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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...

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...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

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...

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...

Cross Country Education is seeking a local contract nurse RN School RN for a local contract nursing job in Downey, California. Job Description & Requirements Specialty: School RN Discipline: RN Duration: 41 weeks 36 hours per week Shift: 12 hours...

firsthand Health in Albuquerque, NM, seeks a remote Triage Nurse to provide telephone and electronic triage support. The role requires strong triage skills, 3+ years of ER experience, and a BSN or ASN. Benefit offerings include health coverage, a...

UnitedHealth Group is seeking a Registered Nurse Clinical Annotator to support AI-driven prior authorization in healthcare. You will interpret clinical data, apply guideline-based criteria, and ensure accurate annotations for model training. This...

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...

UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient criteria, preauthorizations, and ensuring medical necessity while applying evidence-based...

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...

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...

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...

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...

Vivo Care is seeking a Care Navigator to build trusted relationships with patients, triage vital signs, and promote health behavior change. You will work with the care team to conduct wellness calls and develop action plans to improve health and...

Ecumen is hiring a Triage Nurse (RN) for telephone-based care in Shoreview, MN. The role supports Assisted Living and Hospice by providing triage guidance, documentation, and follow-up, all from a remote-friendly setting. The position...

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 healthcare solutions company is seeking a remote Case Management Nurse to lead a multidisciplinary team providing holistic care. The role requires a compact RN license and offers a pay range of $37.00/hr - $39.00/hr. Candidates should have 3...

RN Triage Nurse - Remote job at Get It - Healthcare Location: Jacksonville, FL Job Description: Are you a Registered Nurse with pediatric and adult care experience looking for an exciting new opportunity? We are...

Great Lakes Management Company is seeking a Remote Triage RN to cover after-hours triage calls from various sites. This PRN/on-call role requires an RN licensed in MN, WI, or CO, with 5+ years in home health, assisted living, or long-term care...

A dedicated home health organization seeks a Full Time Registered Nurse (RN) in Jourdanton, Texas. You will provide high-quality nursing care, collaborate on personalized care plans, and leverage innovative technology to improve patient outcomes.

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.

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...

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...