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Job ID: 25-282199 Job Title: 'CWP Immunizing Nurse - Vaccination Initiative' Position Type: Full-Time Contract Role Location: Garden Grove, CA 92843 Work Type: Floating -...

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...

Nurse Consultant I (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,...

CVS Health is seeking an Oncology Nurse Consultant (RN) for a 100% remote role spanning the contiguous U.S. You will lead clinical care coordination and utilization management within the Oncology Care Model, guiding members through diagnosis,...

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...

Nurse Appeals Location: Nashville Tennessee (This role is open only to residents of Tennessee). Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum...

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...

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...

The Clinical Quality Assurance Coordinator is responsible for ensuring case reports are of the highest quality and integrity, and in full compliance with client contractual agreements, regulatory agency standards and federal and state mandates.

Cincinnati Children's is seeking a registered nurse to join the After Hours Nurse Helpline on a remote, full-time schedule with rotating weekends and holidays. The role supports patient care when offices are closed and requires adaptation to a...

**Job Description**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 for excellence in cancer treatment, research and...

The Connection Center Virtual Registered Nurse (RN) delivers high-quality, patient-centered care remotely through telephonic and video interactions, covering the full nursing process from assessment to evaluation. Works with interdisciplinary...

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...

Everlywell is a digital health company pioneering the next generation of biomarker intelligence-combining AI-powered technology with human insight to deliver personalized, actionable health answers. We transform complex biomarker data into...

*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...

Comagine Health in Alabama is seeking Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective utilization reviews. This is a full-time remote role supporting...

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...

Make written and oral reports/recommendations to the attending physician, Medical Director, or the DON concerning the status and care of the residents. • Agree not to disclose resident's protected health information and promptly report...

Iris Telehealth is hiring PMHNPs for 100% remote consult-liaison telepsychiatry in Texas. Earn $120/hr with a sign-on bonus, working 13–16 overnight shifts per month, including weekends. Roles require Texas PMHNP licensure, 2 years...

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...

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a...

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...

Beth Israel Lahey Health is seeking a Per Diem PAT Nurse for Milton Hospital. The role, initially on-site for orientation, moves to a fully remote schedule with flexible shifts. You will perform pre-admission assessments and coordinate...

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...

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...