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The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the...

The Veterans Health Administration in East Orange, NJ seeks a Registered Nurse to serve as Community Care Coordinator. You will coordinate care across VA and community providers and guide Veterans through their care options.

Experience 2-5 years needed. Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

Cunningham Children0s Home in Urbana, IL seeks a Nurse Case Manager to support residential programs with medical case management, screening, education, counseling, and medication management, while networking with community health providers. The...

Sr. Clinical Coding Nurse ConsultantExplore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for...

Concurrent Review Registered Nurse (RN) Location: Fully remote. Our client is seeking an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role, you will perform concurrent...

Abbott is seeking a per-diem RN trainer in the Durham, NC area to deliver Face-2-Face training for home testing customers. You will guide finger stick collection, explain PT/INR device use, and assist with reporting responsibilities. The...

Iris Telehealth is seeking PMHNPs for 100% remote consult-liaison opportunities in IP/ER/ED settings. The role requires 32 hours per week with 15 shifts monthly, including overnight shifts from 7-9pm EST/CST and weekend coverage.

Clinical Appeals Specialist The Clinical Appeals Specialist completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Specialist utilizes...

Children's Mercy Job Opportunity Do you envision finding a meaningful role with an inclusive and compassionate team? At Children's Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the...

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...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

JOB DESCRIPTION Job Summary Work Location: California - Ability to work remote, but selected candidate must reside in the state of California. This position requires California RN Licensure. Candidates must...

Job Title Pay Rate: $27.50 per hour Work Mode: Fully Remote Duration: September to February with possible extension Responsibilities: Work telephonically with claimants, physicians, employers, and customers to ensure...

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...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

Too many women spend years being told their pain is normal. They wait a long time for a diagnosis, cycle through treatments that do not work for them, and often end up managing debilitating symptoms on their own. At Montu, we see these patients...

Case Manager LVN Days Join our team in Los Angeles, CA, as a Case Manager LVN, focusing on patient care coordination and discharge planning. Position Details: Contract: 13 weeks, 40 hours/week, 9am-5:30pm, includes...

Job Summary The Supervisor Nurse Specialty role, is responsible for leading and overseeing a network of contracted nursing agencies supporting home-based and specialty pharmacy services. This role manages nursing contracts and agency...

Trinity Health is seeking a Night Shift RN Utilization Review in Grand Rapids, MI, offering full-time work with remote options. You will review assigned cases against criteria and payor guidelines to ensure proper reimbursement and medical...

Optum is seeking a registered nurse in Hawaii to assess needs, interpret requirements, and identify solutions while working with minimal guidance. You will interpret clinical documentation, support care decisions, and coach peers as an expert...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding experienced RNs to its clinical...