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Centene Management Company LLC is seeking a Licensed Practical Nurse to analyze prior authorization requests and determine medical necessity in New York. You will work with healthcare providers and the authorization team to ensure timely,...

Registered Nurse Long Beach, CA 90813 Overview Salary Range $47.00 - $56.40 Hourly Level Experienced Position Type Part Time Job Shift Day Description The Registered Nurse (RN) works under the direction of...

Cambia Health Solutions is seeking a dedicated Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews, ensuring medical necessity and cost-effective care. You will collaborate with interdisciplinary teams,...

Tennova Healthcare- Turkey Creek Medical Center is seeking a PRN Remote Clinical Utilization Review Specialist to evaluate the necessity and efficiency of hospital services and to support payer requirements. You will review admissions and...

About HCSC At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be...

Clinical Integrity Documentation Specialist Location: Remote Facility: Ascension Wisconsin Hospitals Department: Clinical Integrity Documentation Schedule: Days | Full-Time Salary Range: $79,511.52-$110,834.59...

Medication Nurse - Substance Use Disorder Treatment CRI-Help is a substance use disorder treatment center with several locations across Los Angeles County. We've been around since 1971 and are noted as an organization practicing integrity...

Facilitates the provision of timely and effective patient care under the supervision of licensed members of the healthcare team. Helps maintain a safe and clean environment in order to enhance department operations. Patient care is delivered...

Lana'i Community Health Center is seeking a Clinical Support Registered Nurse (RN) to provide administrative and clinical support to medical providers, enhancing workflow and patient care. The role primarily involves remote support with occasional...

Job Summary: We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, or Operating Room to perform utilization review duties. The Registered...

Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

Managed Medical Review Organization seeks a licensed RN for a home-office, remote role focused on telephonic customer service and clinical documentation. The position emphasizes quality review, case management, and adherence to policy, with...

Optum is seeking a registered nurse in Hawaii to assess needs, interpret requirements, and identify solutions while working with minimal guidance. You will interpret clinical documentation, support care decisions, and coach peers as an expert...

Prolific is recruiting Registered Nurses to train and evaluate AI models. You may be invited to join as a Domain Expert participant and get paid for AI tasks. You'll complete a quick test to assess your skills and suitability, with flexible,...

American Health Plans Franklin, TN 37067, USA Description American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for...

UnitedHealth Group is seeking a SSBV Clinical Claims Review RN for a remote role nationwide. You will perform administrative reviews of inpatient hospital claims, document determinations, and ensure accurate use of screening criteria to support...

Job Description The Stepping Stones Group is seeking a Registered Nurse (RN) for a contracted, school-based placement in Montebello, CA for the 26/27 school year!

Baptist in Meridian, MS seeks a Specialist-Clinical Documentation III RN to evaluate day-to-day documentation practices and advise the clinical team on accurate diagnoses and coding. The role requires five years of acute care experience,...

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will work with physicians, case managers, and providers to ensure appropriate, cost-effective care for chronically ill and frail patients...

Job Description The Research Nurse Coordinator III is responsible for all activities associated with clinical study coordination, subject enrollment, data management/integrity, regulatory compliance, project/study evaluation...

## Clinical Documentation Specialist - RN (Remote)Apply: Fully Remote: Covington, LA: Full time: Posted Today: R13037At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to...

To support a specialized endoscopy clinic, the remote Minnesota Licensed RN Specialist will assess patient needs, implement nursing interventions, and evaluate care outcomes while coordinating with healthcare team members.Key...

Sedgwick is seeking a Telephonic Case Manager to join our team as a US-based remote, full-time role. You will collaborate with injured workers, employers, and medical providers to develop case management strategies that promote medical recovery...

Novitas Solutions, Inc. seeks a Clinical Review Nurse to review and substantiate medical determinations for health claims. You will assess medical necessity, service levels, and appropriateness of care under national and local policies,...

Highpoint Health Sumner is seeking a Registered Nurse (RN) Clinical Documentation Specialist to join as a remote FT (days). You'll contribute by applying plan-of-care interventions and driving patient-care innovations with advanced technology.