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Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site training in Mishawaka, Indiana. The position emphasizes reviewing medical necessity, insurance requirements, and...

Details Client Name Providence SoCal Shared Services Case Management Job Type Travel Offering Nursing Profession Registered...

OpTech is seeking a Registered Nurse (RN) to support utilization review and clinical review activities for a Michigan health plan. This role involves evaluating medical services for medical necessity, level of care, and clinical criteria. The...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Highpoint Health Sumner is seeking a Registered Nurse (RN) Clinical Documentation Specialist to join as a remote FT (days). You'll contribute by applying plan-of-care interventions and driving patient-care innovations with advanced technology.

Valeris is hiring a Patient Support Nurse to guide patients and caregivers through therapy, offering education, care coordination, and psychosocial support entirely via telephonic channels. The role emphasizes documenting interactions,...

To support an upcoming clinical project, experienced Registered Nurses (RNs) will find a fully remote contract opportunity as a Remote RN Clinical Consultant, focusing on conducting comprehensive medical record and clinical chart reviews while...

Cambia Health Solutions is seeking an experienced Utilization Management Nurse to support our Clinical Services team. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and appropriate care, while...

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...

State of Washington's Nursing Consultant role conducts investigations and inspections for Region 1C to ensure long-term care providers meet WAC and RCW requirements. This highly independent position manages a worklist, travels to facilities, and...

Medical Review Nurse III Fully Remote • Windsor Mill, MD Overview Salary Range $80,000.00 - $95,000.00 Salary Position Type Full Time Education Level 4 Year Degree Description At RELI Group, our work is...

Job Description ProMed Staffing Resources is seeking several Registered Nurses (RN) with 2 years of recent Utilization Review experience and we're offering amazing benefits...

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...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

Job Summary: We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, or Operating Room to perform utilization review duties. The Registered...

Registered Nurse - Review Analyst | Remote | Contract Walker Healthforce is seeking a Registered Nurse - Review Analyst with 2-4 years of clinical experience to provide clinical utilization reviews, evaluate medical...

Sedgwick is hiring for a Clinical Consultation Triage Nurse in a remote, full-time role. You will triage calls, assess needs, and provide care guidance to determine the appropriate level of care, while supporting return-to-work goals. The...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Workers' Compensation Care Coordinator Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors and...

*This role will require the successful candidate to work the shift of Monday to Friday, 1pm to 10pm Central (2pm to 11pm Eastern). The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This...

Description: Job Summary: Provides consultation and leadership in designated areas of expertise independently. Collaborates with interdisciplinary teams and stakeholders to address issues and achieve project objectives.

Explore a World of Opportunity with the State of Georgia! We are the force that drives Georgia! Georgia State Government is a large enterprise, composed of various agencies and entities with a common goal to improve the lives of...

Registered Nurse - Case Management - Travel | Torrance, California Estimated Weekly Pay: $1935.10 Start Date: 10/26/2026 | Duration: 13 Weeks Shift: 5 x...

Real Job 3266306 *Works with any dept, if patient complaint arises* *Experience in Critical Care or ED is a plus* *weekends will not typically be required UNLESS survey is on site* *2 years experience required, hard stop*...