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DescriptionYour Role 100% Remote. You will triage calls from our clients in the following manner: 1) assess the needs utilizing injury algorithm guidelines; 2) give appropriate care advice, and 3) disposition to the appropriate...

River Valley Child Development Services Inc seeks a Child Care Nurse Health Consultant to provide technical assistance and develop trainings on health, safety, and nutrition for childcare providers in WV. This exempt, full-time role offers remote...

Position Summary Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality,...

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,...

Cascadia Healthcare is seeking a PDPM Clinical Resource Nurse (RN or LPN) to support our skilled nursing facilities remotely, with regional travel to Idaho, Oregon, Washington, Montana, and Arizona. You will serve as a reimbursement expert on...

NurseRemotely seeks an experienced nurse liaison to coordinate care and share critical medical information among the Injured Worker, the Insured, and the Carrier. This remote, field-based role requires travel within your region and focuses on...

Comagine Health is seeking an RN to perform Clinical Review work and QIDP reviews. The team member will serve as the QIDP (.5 FTE) and as a nurse clinical reviewer (.5 FTE). The role requires applying Alabama Medicaid criteria to determine medical...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Clinical Reviewer RN - Alabama Alabama, US 30+ days ago Requisition...

Cascadia Healthcare is seeking an experienced PDPM Clinical Resource Nurse (RN or LPN) to support our skilled nursing facilities remotely. You will serve as a trusted resource for PDPM reimbursement, MDS coding, and CMS compliance, coaching teams...

Molina Healthcare is hiring a remote RN Care Manager. Preference for candidates in Washington State. This role will be working Pacific Standard Time hours. This role supports Medicare members through telephonic case management and...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role requires an Associate's degree in Nursing, NC RN licensure,...

Synergy-Healthcare-USA-LL seeks an experienced, bilingual Spanish Nurse Case Manager to advocate for members and guide them through the healthcare and insurance landscape. The role supports remote work with occasional travel to client sites in...

Medix is seeking a Remote Utilization Review Registered Nurse (UR RN) to bridge clinical care and hospital operations from a remote setting. Join a team optimizing patient care while safeguarding revenue integrity, with a compressed 4-day week,...

Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides...

Knowtion Health seeks an Appeals Nurse to review medical records and support denials appeals for Medicare, Medicaid, and other payers. You will craft detailed analyses and letters, aligning criteria with payer policies to secure appropriate...

Michigan Public Health Institute (MPHI) is seeking a Nurse Consultant - Tuberculosis to coordinate and enhance Michigan's TB program, connecting providers with TB experts and promoting best practices across the state. The role focuses on...

UnitedHealth Group in El Paso, TX is seeking a Field RN Service Coordinator 1 – Case Manager to remotely support members with holistic assessments, care planning, and coordination across health and community services. The role emphasizes...

Clinical Documentation Integrity Specialist IIThe Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of...

Centene Corporation seeks an experienced Registered Nurse to join our remote care management team for New Jersey. You will develop and coordinate complex care plans, assess needs, and work with providers to improve outcomes across the member...

Asure Wound Solutions seeks a Clinical Specialist, Wound Care Supplies in the Boston area. This is a remote position requiring you to reside in the area, with travel up to 2 hours for nursing homes and long-term care sites. The role...

IQVIA is seeking a Flex Nurse Educator to deliver remote patient education and provide in-field support during territory vacancies. This is a non-clinical, educational role requiring a valid RN license and strong communication skills. The...

Medical Director Services PC is seeking compassionate RNs or LPNs for a Hybrid RN/LPN – Patient Monitoring & Care – Remote role. You will monitor patients' vitals via our RPM platform, review biometric data, and identify abnormal trends while...

U.S. Army Family Nurse Practitioners perform the highest level of quality care for Army Soldiers, retirees, and their families. If you are looking to combine your skills as a family nurse practitioner and your passion for patient care with the desire...

Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will...

An educational institution in Kentucky is seeking a Nurse Coordinator for the Human Development Institute. This full-time position involves reviewing care assessments, providing technical assistance, and requires 8 years of related experience and...