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Maine Community Health Options is seeking a Clinical Specialist who provides clinical decision-making support and coordinates community resources to support medical management. This role analyzes documentation for medical necessity, collaborates...

Public Health Nurse We are pursuing qualified candidates to fill Public Health Nurse positions within the Department of Public Health. This position provides public health nursing services in a facility or in the field, at the individual,...

Job Summary: The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any...

$3,000 Sign On Bonus, details will be provided during Interview. About Sunnyside Nursing Post-Acute Care Centrally located in Torrance, California, Sunnyside Nursing and Post-Acute Care provides sub-acute nursing...

LVN Treatment NurseJoin our Community of Caring at Beachside Post Acute At Beachside Post Acute, we believe that you and your loved ones deserve the very best health care, living facilities, and quality of life possible. Our...

Telephone Triage Nurses Remote Nurse - High Volume Claims Call Specialist Location: Remote (Work from Home) Hours: Full-time, 3Pm-11pmSA (Monday Friday) Must Reside in South Africa Overview: We are seeking a tech-savvy,...

Mass General Brigham Health Plan Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we...

Highmark Inc. is seeking a full-time remote Health Care Case Management professional. Responsibilities include reviewing care plans, ensuring regulatory compliance, and identifying opportunities for Health Coaching and case management...

Telehealth Nurse Practitioner (APRN) for our Skilled Nursing and Post-Acute Facilities - Remote, covering Kentucky, West Virginia, and Ohio Compensation: $105,000 - $125,000 Annual Salary Benefits: Medical, dental, vision, life...

Case Management Nurse II Under supportive supervision, the Case Management Nurse II position supports the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of...

Job Title This position is fully remote, however, you must reside in the State of Texas. The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the...

A healthcare technology company seeks an experienced Registered Nurse for a remote role providing clinical technology services. This position is for independent contractors, focusing on chart reviews and clinical data analysis. Candidates should...

CVS Health is seeking a Utilization Management Nurse Consultant (Medical Review) to join our remote team. You will assess medical necessity, apply criteria, and collaborate with providers to ensure timely care for members. This 100% remote...

Job Title: Registered Nurse (Navy Nurse Corps) Category / Component: Officer • Both Overview Navy Nurse Corps Officers deliver professional nursing care to service members, families, and global communities in leading edge military medical centers,...

Job Title: Registered Nurse (Navy Nurse Corps) Category / Component: Officer • Both Overview Navy Nurse Corps Officers deliver professional nursing care to service members, families, and global communities in leading edge military medical centers,...

Cambia Health Solutions, Inc. is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews for member care across multiple states. The role emphasizes applying clinical criteria, ensuring medical...

Prenuvo is seeking a Nurse Practitioner to conduct remote results review consultations by phone and video. You will review imaging and lab results, explain findings, and agree on next steps with patients. This remote contractor role reports...

Clinical Review Nurse - Concurrent Review TX All On-site Share on Job Description Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday – Saturday 8am-5pm CST- schedule is firm- no flexibility...

Arkansas Blue Cross Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews for prior approvals, network exceptions, and various inpatient/outpatient cases. This role ensures medical necessity aligns with...

LTSS Service Coordinator – RN Clinician (RN Case Manager) Eastern Ohio Hiring in the following counties: Richland Franklin Muskegum Guernsey Noble Washington Morgan...

Details Client Name The Angeles Clinic and Research Institute - Crisis Response Job Type Travel Offering Nursing Profession...

SCAN is seeking a Medical Management Specialist-RN in California to promote quality and cost-effectiveness of care under regulatory guidelines. You will support utilization management, conduct reviews, and coordinate with the Medical Director for...

FUNCTION Cares for residents under the direction and supervision of a registered nurse or a licensed practical/vocational nurse. QUALIFICATIONS The requirements listed below are representative of the knowledge, skill...