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Legal Nurse Consultant (RN) – Contractor Apply your clinical expertise to the intersection of healthcare and legal services as a Legal Nurse Consultant. In this role, you will support attorneys by analyzing medical records, evaluating...

WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to...

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,...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted,...

Benefits We Offer: Comprehensive health, prescription, dental, vision, life, and disability plans Competitive pay rates Referral opportunities ? Refer a friend & Cash in! Travel reimbursement and per diem...

A leading health care provider is seeking a Massachusetts Telehealth Nurse to assist patients in accessing care through phone consultations. Candidates must have a valid RN license in Massachusetts and 3+ years of clinical experience. The ideal...

Real Job 3266306 *Works with any dept, if a 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* *First time travelers...

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*...

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.

Nurse Care Manager Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's shaping the...

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...

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...

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...

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...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

Nurse Consultant II (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

Medix™ is seeking a clinically strong, detail-oriented Registered Nurse to join our Utilization Review team in a fully remote role. You will conduct medical necessity reviews, determine appropriate patient status, and collaborate with physicians...

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...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote capacity. The role reviews inpatient and outpatient services using evidence-based criteria, authorizes care with providers, and escalates cases as needed.

Job Summary: The Clinical Nurse Specialist role at Kaiser Permanente Southern California Region is a clinical manager who partners with the operational manager to ensure that nursing staff delivers safe and effective care. The role is built...

JOB DESCRIPTION This RN will act as a Care Manager supporting our Michigan Medicaid members, identified with complex medical needs. The Medicaid Care Manager will support them to ensure a successful health outcomes. The position includes...

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...

UCLA Center for Prehospital Care is seeking a Fire Department Nurse Educator for a per-diem role supporting emergency medical services in affiliated fire departments and law enforcement agencies in Los Angeles County.The position involves...

Centene Corporation is seeking a licensed practical nurse (LPN) to analyze prior authorization requests for medical necessity and the appropriate level of care. You will collaborate with providers and the authorization team to ensure timely...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...