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Montefiore St. Luke's Cornwall is seeking a Clinical Documentation Integrity Specialist (CDIS) to improve the quality and completeness of clinical documentation. You will work with physicians and clinicians to ensure documentation reflects the...

Job OverviewPay Range: $46.76hr - $51.76hrRequirement/Must Have5+ years Clinical nursing experience.2+ years Care Management.Bachelor's Degree in Nursing.In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required...

Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

Managed Medical Review Organization is seeking a skilled registered nurse for a remote, home-office role. The position emphasizes telephonic/customer service, accurate documentation, and clinical review duties without face-to-face patient contact.

Health Screener The primary responsibility of the Health Screener is to provide coverage in the field ensuring that health screenings are completed accurately and on time. Maintain a safe and professional environment for clients and...

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...

Corrections Registered Nurse (RN) Setting: Corrections Job Type: Travel Pay: $2400 / Week Hours: 40.00 Location: Los Angeles, CA The Correctional RN works in collaboration with other healthcare...

Job Description Registered Nurse (RN) -Los Angeles,CA Local Pay: $56.75/hour (W2) Join our team and make a meaningful impact by delivering exceptional...

UnitedHealthcare is seeking a Level2 Registered Nurse to deliver comprehensive diabetes self-management education and coordinate care for adults with type 2 diabetes. The role emphasizes patient education, telehealth visits, and collaboration...

Oregon Department of Corrections is seeking an experienced Institution Registered Nurse for a limited-duration role based in Salem, OR, with remote work options. The RN will review medical records, assess care adequacy, and coordinate services...

Schedule: Flexible Shifts! You provide your manager with the days and start/end time you are available to complete your hours. All United States time zones are welcome. PRN opportunity to work 20-30hrs per week Job Location Type:...

VHC Health in Arlington, VA is seeking a Virtual Nurse/Nursing Care Partner to provide indirect nursing care to assigned patients across inpatient units via remote technology. The role supports admissions, education and discharge planning with...

CVS Health is seeking an RN for utilization management, coordinating care and determining coverage for members. The role requires clinical judgment, strong communication with providers, and the ability to work in a fast-paced setting. The...

Description: FAMILY NURSE PRACTITIONER JOB SUMMARY Provides continuous and comprehensive services necessary for the promotion of optimal health, prevention and treatment, in an underserved community clinic. To perform a variety of advanced clinical...

Diabetes Specialist Nurse Are you a passionate and experienced Diabetic Specialist Nurse looking for flexible and rewarding opportunities? We are inviting skilled professionals to join our Healthcare Professionals Network for a series of...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Preservice Review RN - Remote in HI (2392416) Preservice Review RN - Remote in HI - 2392416 Optum is a global organization that delivers...

Independent Contractor Registered Nurse Attention all Registered Nurses, we are calling you to partner with us as independent contractors providing services to our Military Service members. We primarily work weekends, with some...

CVS Health Nurse Role We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply,...

NTT DATA is seeking a BPO Clinical Review Specialist in the United States, with remote work available for Florida residents. The role requires an active RN license (Florida or Compact) and at least 3 years of appeals, utilization management, or...

Where You'll Work Founded in 1926, Dignity Health - Glendale Memorial Hospital and Health Center is a 334-bed, acute care, nonprofit hospital. Serving over 70,000 patients annually, the hospital offers a full complement of...

Sentara Health Plans seeks an RN Clinician to perform utilization management and claim reviews across inpatient and outpatient settings. The role supports pre/post payment reviews and authorization assessments, ensuring compliance with policy and...

Visiting After Hours Registered Nurse (RN) Work-from-Home, responding to phone calls triaging care which may include visiting participant's residence when medically necessary Our Visiting After Hours Registered Nurse (RN) work a...

Ensemble Health Partners is seeking a Virtual Utilization Review Supervisor to lead utilization reviews, ensure medical necessity, and drive revenue integrity across the care continuum. You will work with physicians, nurses, and coding...

WORK REMOTELY after training! CANDIDATE MUST RESIDE IN THE METROPOLITAN NEW YORK AREA! !! Process all requests for services in accordance with Medicare and NYS Medicaid guidelines as well as departmental criteria and...

See Your Work in a New Light At LUX Infusion, we're reimagining infusion care to be more human, supportive, and connected. Inspired by lux—meaning light - we guide patients, providers, and partners through complex therapies with...