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Vaya Health seeks a Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical necessity. You will reference standardized criteria and coordinate with physician peers when needed. This role is part of a...

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...

CompuGroup Medical is seeking a licensed practical nurse (LPN/LVN) or RN to join our Remote Patient Monitoring program. You will manage a panel of patients with chronic conditions from a home office, reviewing vitals, coordinating with providers,...

UnitedHealth Group is seeking a Nurse Annotator to support AI-powered prior authorization processes. You will review medical records, annotate data, and apply UM guideline criteria to ensure clinically sound labeling for AI training. The...

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...

A healthcare technology company is seeking an experienced On-Call Registered Nurse (RN) for a remote, part-time position. This role offers flexibility and the opportunity to support patient care from home. Candidates must possess a current Compact...

Premera is a health plan seeking a licensed RN for a Care Coordinator - Clinical Appeals role. You will review inpatient, concurrent, and retrospective requests to determine medical necessity and appropriate care across plans. You will...

Payfuture Technologies is looking for an RN Triage Nurse to provide remote telephone triage care. Ideal candidates have at least 5 years of experience in nursing, preferably in settings such as Emergency Departments or call centers. The...

First Coast Service Options is seeking a Clinical Review Nurse to evaluate medical necessity, coverage, and payment levels for Medicare-related claims. The role applies clinical knowledge to determine the appropriateness of care in line with CMS...

A national healthcare recruiting firm is seeking remote workers fluent in Spanish for a role supporting HEDIS project management. Responsibilities include coordinating the collection and abstraction of medical records, participating in vendor...

Cadence in Dallas, TX is seeking an RN Supervisor to lead a remote team of Registered Nurses in a high-volume triage environment. This role demands strong clinical judgment, operational management, and performance coaching to maintain quality...

A healthcare quality organization is seeking a Nurse Reviewer to support Medical Review Services. The role involves conducting detailed medical necessity reviews for Medicaid claims in a remote work setting. Candidates should have a BSN with...

Building Location: Essentia Health 45th Street Clinic Department: 3661800 FAMILY PRACTICE - 45TH ST Job Description: Essentia Health is seeking a Licensed Practical Nurse or Certified Medical Assistant to serve in our family practice at our 45th...

About Us Galileo is a team-based medical practice working to improve the quality and affordability of health care for all. Operating across 50 states, Galileo offers high-touch, data-driven, multi-specialty, longitudinal...

Providence Home Services Oregon is seeking a Clinical Documentation Specialist, Registered Nurse (RN) for a full-time, day-shift remote role open to multiple states. You will review OASIS admission documents and Plans of Care to ensure CMS...

A leading Quality Improvement Consulting Company is seeking an RN Health Care Facility Surveyor to conduct compliance surveys across various healthcare facilities. The role is heavily focused on ensuring quality standards are met, involving...

Amergis Staffing is currently seeking Certified School Nurse for the 2026/27 school year in the Fullerton, CA area. Position Details: Must have CA SCRN Hours/Week: 6 hours daily (sub role must be okay...

Company : Highmark Health Job Summary This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource...

Pomelo Care is seeking a Pediatric Triage RN for overnight shifts (9pm–9am ET) to provide patient-centered triage for pediatric cases across the United States. This full-time role involves three 12-hour shifts weekly, with weekend and holiday...

Sagility LLC is seeking a Senior Care Specialist (RN) to deliver telephonic education to patients and caregivers from a home-based setting. You will follow clinical protocols within nursing scope and collaborate with the Clinical Operations team...

UVA Health seeks a Clinical Documentation Specialist with nursing experience to ensure the clinical story is accurate and complete across the health system. This fully remote opportunity requires at least three years in CDI or a similar...

A leading health care provider is seeking a Massachusetts Telehealth Nurse to assist patients in accessing care through phone consultations. Candidates must have a valid RN license in Massachusetts and 3+ years of clinical experience. The ideal...

A healthcare network is seeking a full-time Registered Nurse for Pre-Admission Testing (PAT) to work remotely. The role involves conducting comprehensive pre-operative assessments, coordinating with the medical team, and ensuring patient readiness...

A leading telehealth provider is seeking a Remote Telehealth Triage Nurse to provide telephone triage and health advice to patients across the United States. Candidates should have a compact nursing license and a minimum of 3 years clinical...

UBC is seeking a Telephonic LPN for their call center in a remote US setting. The role delivers telephonic nursing support, patient education, and resource referrals for client-funded programs. Requirements include an associate degree in...