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Billing Specialist The Carmelite System is a multi-state, not-for-profit senior living organization sponsored by the Carmelite Sisters for the Aged & Infirm operating a network of Skilled Nursing Facilities and Assisted Living/Independent...

Winning Assistants is seeking a Medical Virtual Assistant - Registered Nurse to provide support for a healthcare practice. The role entails submitting prior authorizations, managing referrals, and maintaining patient communications while ensuring...

UVA Health seeks a Clinical Documentation Specialist with nursing experience to ensure the clinical story is accurate and complete across the health system. This fully remote opportunity requires at least three years in CDI or a similar...

Vaya Health seeks a Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical necessity. You will reference standardized criteria and coordinate with physician peers when needed. This role is part of a...

A home care agency is seeking a Part-Time Caregiver and CNA in Richmond, Texas, dedicated to providing personal care in clients' homes. The ideal candidate will assist with daily living activities, including hygiene, meals, and transportation,...

Back Medical Claim Review Nurse | Remote | Washington | Contract Business & Care Management Long Beach , California Contract Aug 11, 2026 Medical Claim Review Nurse | Remote (Washington) | Contract Walker Healthforce is seeking a...

A national healthcare recruiting firm is seeking remote workers fluent in Spanish for a role supporting HEDIS project management. Responsibilities include coordinating the collection and abstraction of medical records, participating in vendor...

CareXM is hiring a Remote Registered Nurse (RN) for early morning triage on a part-time schedule. The role focuses on secure, compassionate after-hours triage for hospice and home health partners, conducted entirely from the nurse's home.

UnitedHealthcare is seeking a Registered Nurse Clinical Annotator to support AI model training for prior authorization in healthcare. You will interpret clinical data, annotate records, and ensure compliance with UM guidelines while contributing...

Become a part of our caring community At Humana, we put the health and well-being of our members at the center of everything we do. As an Onsite Care Coordination Nurse, you will play a vital role in supporting members during critical moments in...

Upper Peninsula Health Plan (UPHP) is seeking a Remote Community Based Clinical Coordinator - Care Manager. The role involves evaluating members, coordinating services, and ensuring high-quality, cost-effective care across care settings.

Join to apply for the Nurse Advocate - Remote- Kansas role at Synergy Healthcare USA, LLC We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate for our new client and their employees.

Base pay range $60.00/hr - $110.00/hr At Crossing Hurdles, we work as a referral partner. We refer candidates to our Partner that collaborates with the world's leading AI research labs to build and train cutting‑edge AI...

A healthcare staffing agency is seeking an RN Health Care Facility Surveyor to work remotely with up to 75% travel. The role involves conducting surveys for compliance with Federal regulations at health care facilities. The ideal candidate will...

UnitedHealth Group is seeking a Registered Nurse Clinical Annotator to support AI-driven prior authorization in healthcare. You will interpret clinical data, apply guideline-based criteria, and ensure accurate annotations for model training. This...

CNA Position at Long Beach VAMC Life in Long Beach is so much sweeter... The community Long Beach, California Long Beach is a waterfront playground located right in the heart of Southern California. Here you can experience it all:...

Sentara Health Plans is seeking an Utilization Review Nurse (RN) for Medicaid with remote opportunities across listed states. The role supports pre-certification, ongoing reviews, and care coordination within licensure. Schedule includes 8am-5pm...

UBC is seeking a Telephonic LPN for their call center in a remote US setting. The role delivers telephonic nursing support, patient education, and resource referrals for client-funded programs. Requirements include an associate degree in...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

Broadway Ventures, a veteran-owned SDVOSB headquartered in Mississippi, seeks an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud referrals. You will apply clinical expertise...

SCP Health is seeking a registered nurse to provide clinical assessment, nursing triage, and telephonic health education. You will guide patients to the correct level of care and collaborate with Telehealth teams to support a wide range of...

A leading health care provider is seeking a Massachusetts Telehealth Nurse to assist patients in accessing care through phone consultations. Candidates must have a valid RN license in Massachusetts and 3+ years of clinical experience. The ideal...

First Coast Service Options is seeking a Clinical Review Nurse to evaluate medical necessity, coverage, and payment levels for Medicare-related claims. The role applies clinical knowledge to determine the appropriateness of care in line with CMS...

A dedicated home health organization seeks a Full Time Registered Nurse (RN) in Jourdanton, Texas. You will provide high-quality nursing care, collaborate on personalized care plans, and leverage innovative technology to improve patient outcomes.

Company : Highmark Health Job Summary This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource...