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Utilization Review Nurse - RN | 100% Remote | Part-Time 10-20 Hours Per Week | Flexible Schedule | Evenings & Weekends Looking for a way to use your nursing experience without returning to a full-time bedside...

Job Description This position will be supporting Oregon Home Infusion Pharmacy. The Home Infusion Clinical Liaison position is responsible for creating and maintaining positive referral relationships in order to...

A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing...

Carewell is seeking an RN Care Advocate to support members remotely across the United States on a 1099 contract basis. You will perform assessments, create care plans, coordinate with providers, and educate members to empower informed decisions.

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of...

Telephonic Nurse Case Manager (Remote) Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To: Karen...

Prolific is seeking Registered Nurses to train and evaluate AI models. If successful, you'll be invited to join Prolific as a Domain Expert participant, where you'll get paid to train and evaluate powerful AI models. Researchers paying up...

Crawford & Company is seeking an experienced RN Telephonic Case Manager to work remotely providing case management services for patients and employees. You will navigate their healthcare journeys, align with URAC standards, CMSA Standards of...

Nurse Consultant Come join our Symbria Team! We are seeking a highly professional and dedicated individual to join our EMPLOYEE-OWNED TEAM as a Nurse Consultant in the pharmaceutical industry at our Pharmacy in Pennsylvania!

Registered Nurse Navigator - Cancer Center Exams - 10 Hour Days Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally...

Job Description & Requirements Remote RN Utilization Management StartDate: 10/15/2026 Pay Rate: $1800.00 - $2500.00 POSITION SUMMARY – Remote RN Utilization ManagementPOSITION DUTIES Reviews medical records...

Job Title: Clinical Prior Authorization Reviewer Job Description This role focuses on reviewing prior authorization requests to determine medical necessity and appropriate level of care in alignment with national standards, contractual...

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Job Description: To show our commitment to you and to assist with your transition into our organization, we will also offer a $ 20,000 sign-on bonus for experienced RNs night-shift only. The Registered Nurse (RN) is a professional caregiver who...

Facilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS. Reviewing paper and electronic medical...

Type: Clinic Somerville , MA SkyBridge Healthcare is currently seeking Registered Nurse with Clinic experience for a 13-week contract in MA. SkyBridge Healthcare is a premier staffing firm dedicated to matching outstanding talent...

Job Description Navigator RN - Breast Center at Providence Saint John's Health Center in Santa Monica, CA. This position is Full-time and will work 10-hour, Day shifts. Join Providence Saint John's...

WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a...

Army Public Health Nurse Job Overview As an Army Public Health Nurse, you'll assess health risks and implement programs to monitor the spread of disease. You'll promote wellness for Soldiers and their families while also informing policy and...

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...

RN - Quality & Safety Improvement Consultant V, Patient SafetyOnsiteDowney, CATravel: Yes, 10 % of the TimePatient Safety Officer RN in acute care hospital setting. You will attend national safety goal monitoring committees, sit on nursing...

Atrius Health, part of the Optum family, seeks a Registered Nurse to deliver effective care within a specialty, adhering to nursing standards. The role emphasizes education, care coordination, and EMR documentation, with remote work flexibility...

Position Summary Monitors the admissions, continued stay, and discharge of patients following pre-established criteria. Assures that patients meet MCG criteria from admission to discharge including appropriateness of level of care. Conducts...

CorroHealth Inc. CDI Specialist position seeks collaboration with physicians, nurses and medical records staff to improve documentation accuracy and coding quality. Focus includes opportunities for diagnosis clarification and DRG assignment,...

R1 RCM Inc. is seeking a Clinical Coding Appeals Nurse to review medical records and draft appeals of denied or underpaid claims. You will apply clinical judgment to DRG downgrades and prepare persuasive letters using ICD-9/10 CM & PCS, CPT,...