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Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting and communicating medical services and benefit determinations. This remote role may require occasional travel to Humana's offices for...

Job Description: This position is full time, with openings on both day shift and night shift. 6:00 am - 6:30 pm. Weekend rotation varies - every other to every third weekend. Self scheduling is offered in this position. Are you searching for a...

A healthcare organization in Connecticut is seeking an HCC Documentation Lead (RN) to coordinate and oversee documentation specialists. The ideal candidate must have a valid RN license, relevant coding credentials, and a minimum of three years'...

EMD Serono is seeking an experienced RN to join the Patient Support Hub as a remote RN, West Coast-focused. You will provide individualized clinical education, product training, and ongoing support to patients and caregivers, leveraging AI-enabled...

A healthcare staffing company is seeking a Remote Registered Nurse (RN) to specialize in triage on a PRN basis. Ideal candidates will have at least 1 year of nursing experience and an active RN license. Responsibilities include conducting patient...

The position is work from home with field visits. JOB PURPOSE This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

CASE MANAGER LIAISON NURSE - OUTPATIENT COMPLEX CARE COORDINATION - PEDIATRICS! MUST LIVE IN WESTERN WA WITHIN COMMUTABLE DISTANCE TO A KPWA MEDICAL CENTER FLEXIBLE ROLE WORKING 4-10'S ~ (3) DAYS ONSITE KPWA MEDICAL CENTER AND (1) DAY REMOTE ~ MON...

St. Louis Children's Hospital is seeking an RN for after-hours triage and nursing support via the Answer Line. The role involves assessing patient needs, guiding care plans, and educating families within established guidelines. Part-time...

RN/Managed Care Coordinator - Remote Healthcare Columbia , South Carolina Contract Hybrid Aug 28, 2026 Case Management - RN Job at a Glance Title: Medical Case Management Nurse Location:Must live...

Molina Healthcare is seeking a Remote Medical Review Nurse (RN) to work within the Central Time Zone. The role requires several years of clinical nursing experience and specific utilization review/coding expertise. You will analyze...

Illingworth Research Group is seeking a Per Diem Freelance Research Nurse to support patients in clinical studies by coordinating care and liaising with healthcare providers. The role involves guiding participants through study protocols,...

HealthDrive seeks a Remote Clinical Support Nurse (RN or LPN) to serve as the central hub for in-house NPs practicing in SNFs/ALFs. You will coordinate care, communicate with physicians, nurses, families, and pharmacies to prioritize needs and...

TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated...

Northwell Health is seeking a Registered Nurse CDI Auditor to validate acute inpatient coded charts and ensure documentation substantiates diagnostic information. This remote position in New York requires a NY RN license, a BSN, and strong...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

To support client care authorization processes, the full-time Clinical Letter Writer will gather and review medical records, draft letters of medical necessity, and communicate with team members regarding client authorizations and recertifications...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

Optum is seeking an Utilization Management Nurse to review medical records, extract key case details, and craft defensible appeal letters in line with process instructions and guidelines. The role requires an RN with an associate degree, 3+...

Gainwell Technologies is seeking a DRG Quality Advisor Nurse for a remote role within the continental United States. The position focuses on QA audits, DRG validation, coding audits, and ensuring compliance with clinical and coding guidelines.

Palo Verde Community College District is seeking an experienced Clinical Documentation Integrity (CDI) Specialist (RN) for a fully remote role based in the US. The position supports quality outcomes, reimbursement accuracy, and regulatory...

BrightSpring Health Services affiliate Starting Point Nursing Services seeks a Tele-Triage Registered Nurse (RN) for remote, part-time work across multiple US locations. The RN will provide on-call triage, develop care plans, and coordinate with...

Description You're a nurse, a patient advocate, and an educator-and you excel at every one of them. In this role, you will be responsible for providing inbound and outbound patient support in a...

Job ID: 26682 *Description* **Now offering sign-on bonuses up to $20,000** Under the supervision of an anesthesiologist, the Nurse Anesthetist (NA) will perform safe anesthesia care, consisting of the following: pre-operative...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

Telenett is seeking a Remote Utilization Review Nurse to review medical records from a home office and determine medical necessity and care appropriateness. You will work with providers to develop compliant care plans and ensure high-quality,...