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Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role in elevating the impact of our medical record documentation. You will conduct daily evaluations and engage in direct communication with providers to enhance...

Where You'll Work Founded in 1926, Dignity Health - Glendale Memorial Hospital and Health Center is a 334-bed, acute care, nonprofit hospital. Serving over 70,000 patients annually, the hospital offers a full complement of...

A healthcare staffing company in Torrance, CA is seeking a Senior Healthcare Recruiter for a remote RN position. The ideal candidate will have at least 1 year of Home Health experience and must possess an active CA RN License. Responsibilities...

State of North Carolina - Health & Human Services in North Carolina seeks a Nurse Consultant I who conducts regulatory nursing home inspections to ensure compliance with federal and state standards. The role involves travel across Central and...

Talantir seeks a Quality Assurance Nurse to evaluate patient care quality, ensure regulatory adherence, and promote infection prevention. The role operates remotely within the USA with an hourly rate of $38–$40 depending on experience.

Molina Healthcare is seeking a Care Review Clinician (RN or LPN) for a remote, full-time position operating 8a-5p Pacific Time, Monday through Friday. You will support clinical member services review processes, verify medical necessity, and ensure...

CorVel Corporation seeks a Nurse Trainer to develop and revise training materials for nursing staff in a clinical setting. You will organize curricula, assess effectiveness, and ensure new hires complete training and QA reviews. The role is...

School Nurse Under direction, to provide basic health services to students; to assist in the planning and implementation of school health programs in cooperation with medical authority and school administrative personnel; to evaluate the...

Travel Clinic Registered Nurse (RN) - $2,403 per week in taxable pay and non-taxable stipend amount. Pay rates are subject to confirmation with tax free stipend determined for qualified candidates. KPG Healthcare is currently seeking an...

Medix™ seeks an experienced Utilization Review Nurse Specialist for a fully remote role in the United States. You will evaluate medical necessity, determine level-of-care decisions, and collaborate with physicians, interdisciplinary teams, and...

Virtual Medical is seeking qualified Registered Nurses to join our fully remote 24-hour On Call Center. We handle incoming calls for clients requiring immediate medical attention and provide assessment, guidance and disposition to the appropriate...

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...

Allina Health is seeking a Nurse Informaticist to join the Information Systems Optimization Solutions team. The role focuses on integrating nursing practice with data science to improve patient outcomes and care quality across inpatient and...

Providence Tarzana Medical Center in Tarzana, CA is seeking a Certified Nursing Assistant for the Cardiovascular Unit. This Full-Time role requires CA Nursing Assistant Certification, BLS, and completion of the Nursing Assistant course, with...

Trillium Health Resources is seeking a Population Health Nurse to provide clinical care management and population health support for assigned members, focusing on prevention, wellness, and outcomes. The role uses nursing judgment as an RN to...

Medlogix, LLC in Hamilton, NJ seeks a Quality Assurance Nurse for a hybrid role, combining remote work with occasional in-office days. The position involves reviewing IME and peer review reports, ensuring accuracy, consistency, and adherence to...

Machinify is seeking a Medical Review Nurse to perform CMS/RAC audits for government payers. This remote role involves working with a multi-location team to review claims, document findings, and support appeals. RAC certification is preferred and...

Centene Management Company LLC is seeking a Licensed Practical Nurse to analyze prior authorization requests and determine medical necessity in New York. You will work with healthcare providers and the authorization team to ensure timely,...

Cambia Health Solutions is seeking a dedicated Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews, ensuring medical necessity and cost-effective care. You will collaborate with interdisciplinary teams,...

SCAN is seeking an HEDIS Nurse to review medical records for Quality Initiatives/NCQA reporting. The role involves outreach to members and providers to ensure complete data and adherence to NCQA guidelines, with a focus on medication adherence and...

Humana is seeking a Behavioral Health Prior Authorization Nurse to join the Wisconsin Medicaid Market (iCare) team. This role involves reviewing the clinical appropriateness of prior authorization requests to ensure they meet medical necessity and...

About HCSC At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be...

CVS Health is recruiting for an RN Concurrent Review Nurse in a remote capacity, focusing on inpatient clinical expertise to ensure medically necessary care across the continuum. The role requires an active RN license and 5+ years of...

Tennova Healthcare- Turkey Creek Medical Center is seeking a PRN Remote Clinical Utilization Review Specialist to evaluate the necessity and efficiency of hospital services and to support payer requirements. You will review admissions and...