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Nurse Appeals Location: Nashville Tennessee (This role is open only to residents of Tennessee). Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum...

Job Summary and Responsibilities As our Licensed Vocational Nurse (LVN), you will provide vital direct patient care, significantly contributing to patient well-being and recovery as an integral part of our compassionate...

Clinical Intake Nurse If you are a Registered Nurse or LPN/LVN looking to leverage your experience to make a difference in your patients' lives while working in a remote setting, we have an incredible opportunity for you! Vivo...

Job Profile Summary Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's...

Job Description Remote Prior Authorization LVN/LPN Location: Remote (United States) Type: W2 Contract (Temporary) | Hours: 40/week Pay Rate:...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

*Job Summary and Responsibilities* As our Charge Nurse, you'll oversee a department of frontline nurses caring for patients. Your previous experience in acute care, LTC, or nursing homes adds tremendous value to our nursing team. Every day...

UM Review Nurse - Texas Astrana Health is looking for a Utilization Review Nurse with a Texas LVN license to assist our Health Services Department in reviewing a high volume of outpatient and inpatient cases. This position will require...

Telehealth Nurse – Providing Virtual Clinical Support & Care Coordination Telehealth Nurse All Seniors Foundation Los Angeles, CA (Remote Possible) About Us: All Seniors Foundation embraces innovative...

AvonRisk Utilization Review Nurse AvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32...

Providing direct leadership and oversight to the UM nursing team, the full-time Utilization Management Nurse Supervisor will manage team performance, conduct performance evaluations, and ensure compliance with regulatory standards in a remote work...

School Nurse St. Paul the Apostle School is deeply committed to serving children and plays a critical role in supporting the health, wellness, and academic success of our students. Our mission goes beyond academics—we provide holistic...

Job Summary Under the direct supervision of a Registered Nurse or physician, performs a variety of patient care functions as assigned and in accordance with the legal scope of competency and within established standards of care, policies and...

Blackbird Health in the United States is seeking a Psychiatric Mental Health Nurse Practitioner to deliver comprehensive psychiatric evaluations, treatment planning, and medication management for children through young adults ages 2–26. You will...

Remote Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set...

*Job Summary and Responsibilities* As our Nurse Shfit Manager, you will be a pivotal health care professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

Utilization Management Representative Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

The Clinical Research Nurse (CRN) will provide direct patient care to patients enrolled in or considering a clinical trial. The CRN, in collaboration with the satellite physician(s), is responsible for the implementation and evaluation of clinical...

Job DescriptionResponsibilities/Job DescriptionAre you ready to use your nursing skills and continue making a difference while not having to be full time or needing to face the physical demands of a hospital or clinic nurse role? On the Telephone...

Case Management Utilization Management Support Primary City/State: Virtual Arizona Category: Case Management Shift: Day Department: Case Management Remote Monday - Friday 7:30am - 4:00pm Great care starts with great people. (Like...

Salary : $107,352.48 - $160,692.96 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: PH5230H Department: PUBLIC HEALTH...

Part-Time Nurse Second Baptist School University-Model® (SBSUM) is currently seeking a Part-Time Nurse for the 2026-2027 school year. This role serves in a variety of capacities including UM campus support and administrative support.

Direct Hire! Exceptional Benefits! Growth potential! Guaranteed interview with client! Benefits Offered: Medical, Vision, Life, Dental, 12...

Job Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members. Providence caregivers are not...