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Seeking an experienced RN Clinical Documentation Integrity Lead to manage and mentor a team of CDI Specialists, ensuring documentation excellence and compliance in a full-time remote position while maintaining frontline CDI review...

Gainwell Technologies LLC is seeking a Nurse Reviewer (RN) to perform clinical reviews remotely in the United States. Responsibilities include reviewing medical records, documenting findings, and supporting decision-making within healthcare...

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...

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...

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,...

A prominent healthcare organization is seeking a Telephone Triage Nurse Line Advisor in Saint Paul, Minnesota. The role requires a current Minnesota RN License and 3+ years of RN work experience. You will independently triage patient calls and...

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,...

hireops is seeking a contract role for a discharge care coordination position in Chicago, IL. This role involves responsibilities for episodic case management and counseling, ensuring follow-up for acute conditions. Qualified candidates...

Gainwell Technologies is seeking a Medical Reviewer (Registered Nurse) to support California healthcare programs. You will use clinical judgment to review medical records, healthcare services, claims, and authorization requests. You will...

EMD Serono is seeking an experienced RN to join the Patient Support Hub as a remote RN, West Coast-focused. You will provide individualized clinical education, product training, and ongoing support to patients and caregivers, leveraging AI-enabled...

Sr. Clinical Coding Nurse ConsultantExplore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for...

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...

Palo Verde Community College District is seeking an experienced Clinical Documentation Integrity (CDI) Specialist (RN) for a fully remote role based in the US. The position supports quality outcomes, reimbursement accuracy, and regulatory...

A leading healthcare provider in Columbia, Illinois is seeking an RN Supervisor for the Patient Access Center, focusing on evening shifts. The role demands strong clinical judgment and communication skills to optimize patient admissions and...

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIESAssess patient health problems over the phone and via secure videoSchedule appointments and refer patientsAdvise and monitor simple home...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

DaMar Staffing is seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. The role covers claims analysis, provider audits, fraud detection, and...

Centene Corp. is hiring a Quality Improvement Coordinator II to conduct reviews of delegated entities for quality, service performance and utilization, and to lead clinical quality initiatives across provider sites. The role involves...

A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities...

National Brain Tumor Society (NBTS) unrelentingly invests in, mobilizes, and unites our community to discover a cure, deliver effective treatments, and advocate for patients and their care partners. NBTS is a leading policy advocacy and research...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Labor & Delivery Metro Denver Women and Infants (W&I) Float Pool RNs will support patients and teams at Highlands Ranch Hospital, Longs Peak Hospital, and University...

A health care provider organization is seeking a Case Management Nurse to coordinate care for members. This role requires a Nursing Diploma and direct clinical experience, along with the current Michigan RN license. Responsibilities include...

RWJBarnabas Health is seeking an experienced Registered Nurse for a remote, day-shift role in New Jersey. The RN will support virtual urgent care navigation, referrals, and care coordination while working with a multidisciplinary team to ensure...

Broadway Ventures, a veteran-owned SDVOSB headquartered in Mississippi, seeks an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud referrals. You will apply clinical expertise...

CareXM is hiring a Remote Registered Nurse (RN) for early morning triage on a part-time schedule. The role focuses on secure, compassionate after-hours triage for hospice and home health partners, conducted entirely from the nurse's home.