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A healthcare organization in Connecticut is seeking an HCC Documentation Lead (RN) to coordinate and oversee documentation specialists. The ideal candidate must have a valid RN license, relevant coding credentials, and a minimum of three years'...

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely,...

Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting and communicating medical services and benefit determinations. This remote role may require occasional travel to Humana's offices for...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

Job Description We are hiring an RN at our Primary Care Shoal Creek location! Monday - Friday, 8am-430pm No Nights, No Weekends, No Holidays Remote opportunity every other week after 4 months MO and KS RN license required BLS required Previous...

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A healthcare staffing company is seeking a Remote Registered Nurse (RN) to specialize in triage on a PRN basis. Ideal candidates will have at least 1 year of nursing experience and an active RN license. Responsibilities include conducting patient...

TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated...

HealthDrive seeks a Remote Clinical Support Nurse (RN or LPN) to serve as the central hub for in-house NPs practicing in SNFs/ALFs. You will coordinate care, communicate with physicians, nurses, families, and pharmacies to prioritize needs and...

Mist Registered Nurse (Rn) – Position Summary The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical support to primary care patients and...

City/State Roanoke, VA Work Shift First (Days) Overview: Sentara Health Plans Roanoke is looking to hire a Care Coordinator- LPN. Sentara Health Plans is hiring a Remote Care...

Rochester Regional Health is seeking a Registered Nurse for the Communications Center (Central Triage). The role combines in-person duties at the Riedman Center with a remote option after completing an in-depth training program. Expect 40...

Working remotely in a full-time capacity, the Registered Nurse Utilization Management will manage complex reviews and processing of authorization requests for various medical services, ensuring compliance with regulatory standards while...

Pacific Clinics is seeking Licensed Psychiatric Technicians (LPTs) and Licensed Vocational Nurses (LVNs) to provide direct patient care in psychiatric and mental health settings. You will assess patients, administer medications, and implement...

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

Job ID: 26682 *Description* **Now offering sign-on bonuses up to $20,000** Under the supervision of an anesthesiologist, the Nurse Anesthetist (NA) will perform safe anesthesia care, consisting of the following: pre-operative...

A healthcare solutions provider is looking for a qualified RN to perform medical reviews and coordinate care for members. This role involves assessing service needs, engaging in patient education, and ensuring compliance with healthcare...

Nurse Navigator 1 The University of Miami/UHealth Department of Medicine has an exciting opportunity for a Full-Time Nurse Navigator 1 to work in the UHealth Campus. Core Job Summary: The Nurse Navigator 1 (H) liaises...

Telenett is seeking a Remote Utilization Review Nurse to review medical records from a home office and determine medical necessity and care appropriateness. You will work with providers to develop compliant care plans and ensure high-quality,...

Back Medical Claim Review Nurse | Remote | Washington | Contract Business & Care Management Long Beach , California Contract Aug 11, 2026 Medical Claim Review Nurse | Remote (Washington) | Contract Walker Healthforce is seeking a...

A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The...

Haven Home Health & Hospice is seeking a Quality Assurance RN (OASIS Certification Required) with COS-C or equivalent certification to review and ensure OASIS accuracy for patients in a fully remote Missouri-focused role. You will work with...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...