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Atrius Health, part of the Optum family, seeks a Registered Nurse to deliver effective care within a specialty, adhering to nursing standards. The role emphasizes education, care coordination, and EMR documentation, with remote work flexibility...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Alliance Liaison If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where...

Oscar Health is seeking a Utilization Review Nurse to join our team. You will review cases, verify medical records, and consult with care providers to assess treatment appropriateness using Oscar Clinical Guidelines, MCG, and InterQual. The...

Appeals Nurse Consultant 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...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and...

BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the...

A leading healthcare company is seeking a Tele-Health Nurse to provide high-quality service for specialty prescription drugs. This role includes case management and patient coordination. Ideal candidates should possess a Vocational or technical...

Springfield Clinic, Springfield, IL, is seeking an RN TeleNurse to triage patient calls, provide leadership within the department, and advocate for patients. The role emphasizes applying the nursing process, clear communication, and coordination...

Job Description: To show our commitment to you and to assist with your transition into our organization, we will also offer a $ 20,000 sign-on bonus for experienced RNs night-shift only. The Registered Nurse (RN) is a professional caregiver who...

Where You'll Work Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

Remote RN Case Manager Market leading managed care organization looking for remote RN Case Managers! Great opportunity! Must have active NY RN licensure for this role. Schedule: Monday-Friday, 8:00 AM-5:00 PM EST Contract Length: 6-month...

Case Manager, RNRosemead, CA, USAWelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. We serve the most vulnerable seniors with better quality and compassion in a...

Job Description This position will be supporting Oregon Home Infusion Pharmacy. The Home Infusion Clinical Liaison position is responsible for creating and maintaining positive referral relationships in order to...

Facilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS. Reviewing paper and electronic medical...

MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare...

Indiana University Health Metro Region is seeking a PRN Psychiatric Nurse Practitioner or Psychiatric Physician Assistant to join our Virtual Care Behavioral Health team. This remote role provides virtual consults across Indiana's emergency...

Employer Industry: Behavioral Healthcare Management Why consider this job opportunityStarting pay up to $50,000 per year, based on experienceFree Teladoc access and visits for employees and eligible...

A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing...

The RN Case Manager manages a continuum of care from pre-admission through post-discharge for assigned patients. Assure that patients and families proceed efficiently throughout the course of hospitalization. Focus of the position is the...

Clinical Appeals Nurse We are seeking an experienced Clinical Appeals Nurse to support the appeal and grievance processes by analyzing and responding to adverse coverage decisions. This role involves clinical judgment, regulatory...

MES Solutions is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator. This 100% remote role focuses on reviewing peer reports, ensuring accuracy, and aligning with client agreements, regulatory standards, and state...

Detroit, Michigan Case Management Contract We are seeking a Remote Case Manager RN with an out of state compact license. This is working with a healthcare organization. EDUCATION AND...