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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...

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...

About This Role The Clinical Consultant RN, Medical Policy Writer role at UnitedHealth Group involves providing clinical leadership for assigned Optum products, focusing on the development of clinical utilization management guidelines and...

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...

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...

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...

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...

Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...

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...

Clinical Grievances Nurse 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...

SCAN Health Plan seeks a HEDIS Nurse to review medical records and support NCQA-driven quality initiatives. This remote role coordinates with members and providers to collect complete data, focusing on medication adherence and preventive...

Job DescriptionJob Summary Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities...

1st TIME OK/ 2 YR EXP required for Utilization Review RN every other weekend required or more depending on unit needs no call or floating required MUST HAVE experience with Milliman Care Guidelines and Acute Hospital Experience!! The Emergency...

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...

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...

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,...

PIH Health in Los Angeles provides timely and effective patient care under the supervision of licensed team members. The CNA helps maintain a safe, clean environment to enhance department operations and delivers patient care aligned with...

Utilization Review Nurse - RN | 100% Remote | Part-Time10-20 Hours Per Week | Flexible Schedule | Evenings & WeekendsLooking for a way to use your nursing experience without returning to a full-time bedside schedule?We're seeking an experienced...

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,...

$15K Sign-On Bonus | Compensation: $120/hr (1099) | W-2 Employment Opportunities Available Only PMHNPs with 2 years of consult-liaison clinical telehealth experience post PMHNP-BC will be considered for this opportunity.

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...

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...

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...

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...

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...