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A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and...

Physicians East seeks a QEC Pre Procedure Screening Nurse for a part-time remote role based in Greenville, NC. The nurse will review patient charts, screen for procedural eligibility, and coordinate with physicians to ensure proper evaluation and...

TEEMA partners with a top healthcare organization to recruit a Clinical Quality Reviewer. You will review medical records for quality and utilization concerns, and prepare clear recommendations for quality improvement. Remote or onsite...

Employment Type: Part time Shift: Description: Hours/Schedule: Every Saturday & Sunday 2:00 p.m. 12:30 a.m. EST Home Care & Hospice Virtual Care Center Coordinator Registered Nurse...

Greenlife Healthcare Staffing is seeking a Registered Nurse Clinical Reviewer for a remote, full-time role with a nonprofit client in New York. The RN should have 1–3 years in utilization review, appeals, and prior authorization and be...

Registered Nurse (RN) - Home Infusion Therapy AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity.

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: Provides consultation and leadership in designated areas of expertise independently. Collaborates with interdisciplinary teams and stakeholders to address issues and achieve project objectives. Coordinates advanced knowledge and...

Utilization Review Nurse - RN | 100% Remote | Part-Time 10-20 Hours Per Week | Flexible Schedule | Evenings & Weekends Looking for a way to use your nursing experience without returning to a full-time bedside...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of...

Consulting Clinical Professional For North Dakota CGM Services Med Supply US is an ACHC-accredited, Medicare-enrolled mail-order supplier of continuous glucose monitors serving patients nationwide. We're expanding into North Dakota and...

Registered Nurse Navigator - Cancer Center Exams - 10 Hour Days Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally...

Public Health Nurse The County of Los Angeles Department of Public Health is seeking qualified candidates to fill emergency Public Health Nurse vacancies related to the homelessness crisis. Under the emergency order, applicants who...

Clinical Operations Nurse Coordinator RN II The Clinical Operations Nurse Coordinator RN II reports to the Manager of Clinical Operations. The Clinical Operations Nurse Coordinator RN II will work independently and collaboratively with...

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...

Evry Health seeks an RN Integrated Care Coordinator (UM) to provide comprehensive care coordination and drive quality outcomes for members across the care continuum. This remote role requires rotating weekend hours for utilization review and...

Peraton's SafeGuard Services seeks a Nurse Reviewer to conduct medical record reviews, applying clinical judgment to claim payments and supporting fraud investigations. Telework is available from any state. The ideal candidate will hold a...

Santa Barbara Cottage Hospital is seeking an experienced RN/LPN to perform remote clinical reviews for appeal cases. You will review medical records, apply InterQual criteria, and prepare clinical determinations for physician review. The...

Job Description & Requirements Remote RN Utilization Management StartDate: 10/15/2026 Pay Rate: $1800.00 - $2500.00 POSITION SUMMARY – Remote RN Utilization ManagementPOSITION DUTIES Reviews medical records...

Job DescriptionRegistered Nurse (RN) Care Management Specialist Location: Remote- Onsite for Training (Must reside within 2 hours of Columbia, SC) Pay Rate: $30/hour ScheduleMonday through...

Telephonic Nurse Case Manager (Remote) Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To: Karen...

JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member...

Support, Inc. is seeking a Nursing Coordinator/Registered Nurse to oversee medical care for individuals with intellectual and developmental disabilities. You will coordinate with physicians and interdisciplinary teams to promote health...

Cabell Huntington Hospital is seeking a casual, as needed Virtual Integrated Care Coordinator (RN) for our CHH Virtual Integrated Care Department. This job is responsible for supporting and...

Utilization Review Nurse Auditor Fully Remote • Mount Laurel, NJ 08054 Salary Range $33.00 - $46.00 Hourly Position Type Full Time Travel Percentage 10% ExamWorks is looking for a Utilization Review Nurse Auditor to join...