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WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to...

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...

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...

EMD Serono is seeking an experienced RN to join the Patient Support Hub as a remote RN, supporting patients and caregivers across the West Coast. The role focuses on clinical education, product training, and ongoing personalized support throughout...

A prominent healthcare company is seeking a Case Management Nurse to conduct comprehensive assessments and develop care plans for beneficiaries. The ideal candidate will have 5+ years of clinical RN experience and a current RN license.

Obran Health is seeking an experienced RN Clinical Coordinator for a fully remote, temporary contract across California-based home health agencies. You will coordinate clinical care, support field clinicians, and ensure documentation accuracy to...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

A healthcare quality organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The ideal candidate will have a BSN and an active RN license, along with experience in medical record review.

Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to...

UnitedHealth Group is seeking an Inpatient Utilization Management Nurse, RN for a fully remote role serving the Sacramento area. The position requires 3+ years in acute care and 1+ year in utilization management, with certification in RN licensure...

A healthcare solutions provider is seeking a Registered Nurse for Claims & Appeals Review. This remote role supports compliance and quality assurance in appeal reviews. Candidates should have a Bachelor's degree in healthcare and valid RN license...

Hospice Telephone Triage RN- FT 6:30a-4p Mon-Fri o wknds (REMOTE) Hospice Telephone Triage RN- FT 6:30a-4p Mon-Fri o wknds (REMOTE) 2 weeks ago Be among the first 25 applicants We invite you to join our growing...

UVA Health is seeking a Registered Nurse (RN) in Utilization Management for a remote role. You will leverage acute care experience to navigate complex clinical scenarios, determine medical necessity, and collaborate with interdisciplinary teams.

We're seeking board certified Nurse Practitioners licensed in Nebraska(multi licensed strongly preferred) with broad clinical expertise and a passion for improving healthcare access and quality. In this role, you'll deliver virtual comprehensive...

Sr. Clinical Coding Nurse ConsultantExplore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for...

St. Louis Children's Hospital is seeking an RN for after-hours triage and nursing support via the Answer Line. The role involves assessing patient needs, guiding care plans, and educating families within established guidelines. Part-time...

Central Health seeks a Nurse Case Manager to identify, screen, track and coordinate care for members with multiple co-morbidities and psychosocial needs. This role may work remotely with occasional travel to Austin, TX, under the Manager of Case...

CareXM is hiring a Remote Registered Nurse (RN) for early morning triage on a part-time schedule. The role focuses on secure, compassionate after-hours triage for hospice and home health partners, conducted entirely from the nurse's home.

A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and...

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...

Winning Assistants is seeking a Medical Virtual Assistant - Registered Nurse to provide support for a healthcare practice. The role entails submitting prior authorizations, managing referrals, and maintaining patient communications while ensuring...

Job OpportunitySeeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the opportunity...

Welby Health is seeking a licensed RN to serve as Care Manager for our remote physiological monitoring program. You will monitor vitals, develop care plans, and provide education to improve adherence and outcomes. In this remote role, you...

Northwell Health is seeking a Registered Nurse CDI Auditor to validate acute inpatient coded charts and ensure documentation substantiates diagnostic information. This remote position in New York requires a NY RN license, a BSN, and strong...

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...