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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...

About This Role The Preservice Review RN position at UnitedHealth Group involves assessing customer needs, identifying solutions to complex issues, and conducting clinical research to support medical determinations. This role is ideal for...

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...

Michigan Public Health Institute (MPHI) is seeking a Nurse Consultant - Tuberculosis to coordinate and enhance Michigan's TB program, connecting providers with TB experts and promoting best practices across the state. The role focuses on...

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...

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...

Job Title: Remote Prior Authorization Registered NurseJob Description We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid)...

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*...

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,...

Details Client Name Providence Health & Services, Southern California Job Type Travel Offering Nursing Profession RN...

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...

*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...

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...

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...

Medical Review Nurse III Fully Remote • Windsor Mill, MD Overview Salary Range $80,000.00 - $95,000.00 Salary Position Type Full Time Education Level 4 Year Degree Description At RELI Group, our work is...

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 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...

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...

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...

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...

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...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Clinical Practice Performance Consultant - Remote in MD (2388976) Clinical Practice Performance Consultant - Remote in MD - 2388976 At...

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...