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Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

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...

*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...

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...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Clinical Consultant RN, Medical Policy Writer - Remote (2389098) Clinical Consultant RN, Medical Policy Writer - Remote - 2389098 Optum is...

The Fountain Group is seeking a licensed RN for a 100% remote, 40-hour week contract role to support medical device safety activities, with emphasis on adverse event processing and regulatory compliance. You will review and escalate...

JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance...

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...

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,...

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.

National Care Advisors is seeking a Nurse Case Manager in the DC/Baltimore area to coordinate case management for eldercare clients, working with families, attorneys, and trustees to support quality of life. The role emphasizes timely...

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...

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...

Client Success Partner – EDPlan Innovations – EDPlan Health- School Nurse Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and...

Job Summary and ResponsibilitiesAs our Educator in Critical Care Emergency, In accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a consultant/resource...

Clinical Practice Specialist The Clinical Practice Specialist directs and elevates evidence based practice across nursing service lines specific to the role. This may span multiple age populations. The Clinical Practice Specialist will...

Guardian Life Insurance Company seeks an experienced RN Clinical Consultant to evaluate short- and long-term disability claims, analyze medical information, assess functional capacity, and support claim decisions. You will collaborate with...

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...

Description Virtual coordination role to support front line clinical staff in care of patients receiving care in the home setting. Serve as an extension to front line staff in patient care logistics management including admission...

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...

Guardian Life is seeking an RN Clinical Consultant to evaluate disability claims, analyze medical information, and provide clinical guidance for claim decisions. You will collaborate with providers, claimants, and vocational specialists to support...

Teladoc Health, Inc. is hiring a Nurse, Care Coordinator to deliver proactive utilization management for members with high-risk needs while supporting coordination among care teams. This remote role emphasizes excellent service across...

willow tree post acute seeks an MDS Resource nurse to support facilities across Kansas with remote coordination and on-site visits as needed. The role emphasizes leadership in nursing administration, quality improvement, and performance management...

Humana Inc. seeks a Field Care Manager II (Physical Health) to assess member needs, plan care, and coordinate resources across Louisiana. This field-based RN role emphasizes holistic care, social determinants, and collaboration with providers to...

This position is offered fully Home based (Remote) As a pharmaceutical support industry leader, UBC is devoted to empowering health solutions for a better tomorrow. We take pride in improving patient outcomes and advancing healthcare. At UBC we...