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Full-time Company Description WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding experienced RNs to its clinical...

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the...

A healthcare management firm is seeking an RN Care Management Coordinator – Compliance Specialist to ensure compliance with relevant regulations and standards. This remote position requires a minimum of five years of clinical experience, an...

Registered Nurse – Utilization Review (Remote) Position Overview: This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation...

Novant Health's Population Health Services Organization (PHSO) seeks an RN Coach to guide patients through telephonic virtual care, chronic-care management, self-management support, and acute triage, delivering safe, high-quality, patient-centered...

Experience 2-5 years needed. Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

Job ID: 33380 *Description*There's nothing more exciting and rewarding than being able to make a significant, positive difference in someone's life. At UCLA Health, you'll experience this joy every day while also enjoying the positive,...

UnitedHealth Group is seeking a Transitional Care Nurse Liaison to educate and support high-risk patients during transitions from acute care. You will work with Boulder Community Health and partners to reduce readmissions through patient...

Registered Nurse - Utilization Review Job Opportunity: Registered Nurse - Utilization Review Facility: Providence SoCal Shared Services Case Management Location: Torrance, CA Employment Type: Travel/Contract Shift: Day (5x8 Hours) 8:00...

Manage CMS and State Administering Agency audits for PACE compliance.Ensure audit readiness and serve as point with audit teams.Champion compliance culture across the organization.Key Responsibilities:Monitor audit universe data and review...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

Case Manager Utilization RN Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does...

DRG Specialist UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position working during standard business hours Monday through...

nirvanaHealth, a RxAdvance Corp. company, seeks a part-time Utilization Management Nurse for a remote role in the United States. You will perform prospective, concurrent, and retrospective medical necessity reviews and care coordination to ensure...

RN Career Transition Opportunity – Nurse Case Manager Are you an RN seeking a rewarding career shift that uses your clinical skills and compassion — without the physical demands of bedside care? QuestPro has the exclusive...

Clinical Quality & Compliance Nurse Reviewer (Remote - Travel within Illinois) Location: Remote with on-site visits across Illinois Salary Range: $73,000-$83,000 annually Position Overview The Clinical Quality &...

About Float Float is the full-stack platform for Specialty Pharma home infusion. We're on a mission to make healthcare safer, easier, and more efficient by connecting SuperNurses to home medication visits - moving all care...

Innovative Systems Group is seeking qualified healthcare professionals to conduct medical management and health education for customers on government programs. The role includes data gathering for regulatory reports and performing assessments,...

Spectrumforce Technologies, Inc. is seeking a Care Manager (RN) to support Medicaid members remotely in Florida. The role involves reviewing referrals, proactive outreach, and guiding members through care management, education, and coordinated...

A health care provider organization is seeking a Case Management Nurse to coordinate care for members. This role requires a Nursing Diploma and direct clinical experience, along with the current Michigan RN license. Responsibilities include...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

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...

Aya Healthcare has an immediate opening for the following position: Outpatient Clinic in Beverly Hills, CA.We'll work with you to build the healthcare career of your dreams. Whether you want a job close to home or across the country, we've got...