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CHOICES Case Management, Inc. is seeking an Administrative Assistant to support our Nurse Case Managers in a fast-paced healthcare environment. This role serves as the operational backbone, ensuring details are handled, communication flows...

The State of Washington's Department of Social and Health Services seeks a Nursing Consultant Institutional in Arlington. You will conduct licensing inspections and investigations, evaluate care quality, and ensure compliance with state...

HBiz seeks a Clinical Appeals Nurse (RN) to remotely support revenue cycle operations. You will review denied claims for clinical accuracy, develop evidence-based appeal strategies, and draft payer-ready documentation to overturn denials and...

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...

Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health...

Care Manager (RN) Remote (WA Pref) Must Have Compact Licensure WA, United States and 1 more Job Description Molina Healthcare is hiring a remote RN Care Manager. Preference for candidates in Washington State. This role...

Comagine Health is seeking a Clinical Reviewer (RN) to evaluate medical necessity, quality and appropriateness of services under the WA L&I contract. This remote role supports case reviews across inpatient, outpatient, and complex imaging by...

Cedars-Sinai in the United States is seeking a Utilization Management Specialist to support UR Nurses, ensure timely, accurate, and compliant utilization reviews, and help maintain payer communications and documentation integrity. You will...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to...

Integra Partners is seeking an LPN/LVN with managed care UM experience to perform pre-service and post-service utilization reviews and appeals for DMEPOS, collaborating with our Medical Director within an NCQA-compliant UM program. The UM...

Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks an accomplished Infusion Referral Intake Coordinator NOTE- THIS...

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...

Western Reserve Area Agency on Aging in North Olmsted, OH is seeking an LPN Community Resource Consultant to assess consumer needs and determine eligibility for WRAAA programs. The role involves educating clients and coordinating with caregivers...

Description Current staff, faculty/adjunct at Herzing University: log into UKGand navigate to Menu > Myself>My Company > View Opportunities to apply using the internal application process. To participate in a remote work...

VHC Health in Arlington, VA is seeking a Virtual Nurse/Nursing Care Partner to provide indirect nursing care to assigned patients across inpatient units via remote technology. The role supports admissions, education and discharge planning with...

Santa Barbara Cottage Hospital is seeking a Telephonic Nurse Case Manager to assess and coordinate care for injured workers. Responsibilities include planning and implementing medical case management, ensuring timely communication with all...

Solomon Page is seeking a travel nurse RN Clinic for a travel nursing job in Tarzana, California. Job Description & RequirementsSpecialty: ClinicDiscipline:...

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individuals...

Comagine Health in Washington State is seeking an experienced Registered Nurse to join our remote Clinical Reviewer team. The role focuses on assessing medical necessity, appropriateness, and quality of care through prospective, concurrent, and...

JOB DESCRIPTION AND POSITION REQUIREMENTS If you reside in one of the states listed in the above Notice to Out of State Applicants, please complete our SAFE‑T TeleSANE interest form. We accept qualified applicants from all states. Shape the next...

HCSC is seeking a remote QOC Nurse under the supervision of the QOC Manager to conduct review and investigation of quality of care issues. The role supports quality improvement activities in compliance with CMS, NCQA and other regulatory...

Comagine Health, a national nonprofit healthcare consulting organization, seeks a Clinical Reviewer (RN) to support the Washington Labor & Industries contract. This remote role leverages nursing expertise to evaluate medical necessity and quality...

Exceptional care starts with exceptional people. For us, this is more than a job- it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to...

Staff Education RN Job Summary: Collaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on...

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...