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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...

Staff Education RN Collaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental goals and...

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...

Job Description WHAT YOU'LL DO As an admissions nurse at VITAS Healthcare, you will be the first face of hospice for patients and families. Your meeting will likely be the first time they...

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...

Utilization Management Nurse Consultant (RN) 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...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

Job Description Join a team that's shaping the future of pediatric care. Children's Hospital Los Angeles is consistently ranked among the top 10 children's hospitals in the nation, delivering world-class care through more than 350...

Clinical Trial Nurse/Nurse Navigator Classification: Temporary Contract January 2027 – September 2027 - Start Date: January 2027 Location: Remote, South Atlantic region, DMV, South Carolina preferred - Salary: $86.50/hr 13/hrs...

Absolute Elder Care is seeking a Remote Nurse Consultant to provide compassionate and expert guidance to seniors and their families. This full-time, remote position includes conducting health care assessments, creating individualized care plans,...

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...

Expedite Healthcare Solutions is seeking a local contract nurse RN Urgent Care for a local contract nursing job in Playa Vista, California. Job Description & Requirements Specialty: Urgent Care Discipline:...

Optum is seeking a Clinical Consultant RN, Medical Policy Writer for a remote role within the United States. You will lead clinical oversight of product medical policies, develop utilization guidelines, and support COE network criteria. The...

Salary : $105,247.44 - $157,542.24 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: PH5230H Department: PUBLIC HEALTH...

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 deeply, innovate with purpose, hold...

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Titanium Healthcare is seeking an RN Clinical Consultant to lead clinical oversight within the Enhanced Care Management (ECM) program for Medi-Cal members in California. You will collaborate with Lead Care Managers and the interdisciplinary team...

Admissions Nurse The Admissions Nurse is responsible for establishing and maintaining positive relationships with customers and referral sources within the community. The Admissions RN is also responsible for developing and increasing the...

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...

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 statements of duties does not exclude...

RN Coordinator - Enhanced Care Management (ECM) POSITION SUMMARY MLK Community Healthcare is seeking a Registered Nurse (RN) Coordinator to be part of our MLKCH Enhanced Care Management program. The RN...

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 Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded...

Lead Care Coordinator The Lead Care Coordinator will provide hands-on expertise to other team members as needed to help ensure that every patient receives the right type of care, at the right time in the right setting, every day. The Lead...

River Valley Child Development Services Inc seeks a Child Care Nurse Health Consultant to provide technical assistance and develop trainings on health, safety, and nutrition for childcare providers in WV. This exempt, full-time role offers remote...