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Humana, Inc. is seeking an Utilization Management Nurse 2 to coordinate, document, and communicate medical services and benefit determinations for our members. You will interpret clinical information to support recommendations and care...

Sedgwick is seeking an RN Field Case Manager to join our nationwide team in a remote, home-based role with occasional travel. You will work with injured workers and medical providers to coordinate care, advocate for treatment, and support timely...

RN/NP Clinical Quality Reviewer Primary Care, Acute Symptom Triage & Travel Health | Contract, up to 25 hrs/week About the Role We are seeking Nurses & Nurse Practitioners with clinical experience in one or more of the...

Grievance & Appeals Nurse, RN Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Reporting to the...

Nurse - Clinical Review The Clinical Review Nurse makes prospective medical necessity determinations on prior authorization requests for HealthHelp's specialty programs, including Diagnostic Imaging, Cardiology, Musculoskeletal, Physical...

Concurrent Utilization Review (UR) Nurse The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews to ensure the medical necessity and appropriateness of healthcare services provided to members...

Join Our Team This outstanding unit is looking for the right RN to join their team of compassionate and driven health care professionals. Join this highly motivated team of caregivers and enjoy a challenging and welcoming environment...

BJC HealthCare is seeking a Clinical Documentation Quality Coordinator to perform second-level reviews, address mortalities, prebill checks, and staff education. The role requires 2 years CDI and nursing experience, RN licensure, and CCDS...

Mercy is seeking an RN II in Advanced Primary Care to provide virtual chronic disease management in collaboration with physicians and advanced practitioners. You will establish patient relationships, monitor vitals, and support panel management,...

Job Description SummaryThe Certified Nursing Assistant is responsible for caring for the personal needs and comfort of residents. The Certified Nursing Assistant performs routine duties within the limits of training and certification in caring for...

$2692.80/week - Job Summary: Provides comprehensive nursing care to obstetric and gynecologic patients, ensuring adherence to established standards of care and the nursing process. Supervises and coordinates activities of nursing staff while...

1st TIME OK/ 2 YR EXP required for Utilization Review RN every other weekend required or more depending on unit needs no call or floating required MUST HAVE experience with Milliman Care Guidelines and Acute Hospital Experience!! The Emergency...

SCAN Health Plan is hiring a registered nurse for clinical review of medical claims and post-service appeals. You will analyze pre/post payments, perform audits, and apply CMS guidelines to determine medical necessity and appropriate care.

Responsibilities USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting top talent and...

Elevance Health, Inc. is seeking a Nurse Case Manager I (RN) to perform telephonic care management for members with complex and chronic care needs. The role supports assessment, development, implementation, coordination, monitoring and evaluation...

Join Silverado Hospice Silverado Hospice covering Los Angeles is part of a nationally recognized team ranked in the top 10 nationwide by Fortune Magazine's Best Workplaces in Aging Services™. Since 1997, Silverado has been delivering...

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. Work Shift: Varies (United...

Company Description WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services,...

Job Title This is a remote, PRN position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values...

We are looking for a Travel L&D RN for a great Travel nursing job in Los Angeles, CA. This L&D Travel nursing job pays for 48 hours a week for 13 weeks. With Wanderly you can compare...

Registered Nurse Pay: $938.00/shift Schedule: Flexible scheduling through Shifts app Openings: 5 Start Date: 09/07/2026 Experience: 2.0 year(s) Certifications: ACLS, BLS Skills: Airway assessment,...

The Registered Nurse is responsible for overseeing the health, wellness, and psychiatric stability of patients receiving Full-Service Partnership (FSP) and broader outpatient behavioral health services. The position is primarily...

Research Nurse (Per Diem) - Greater Portland, OR Area Illingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device industries. These include mobile...

Care Manager (RN) A TEAM OF DIFFERENCE MAKERS: At Author Health, we're revolutionizing how mental health care is delivered, and we want you to be part of it! Our mission is to bring compassionate, high-quality care to...

CVS Specialty Pharmacy Nurse, Clinical Operations CVS Specialty Pharmacy provides medications and support for rare and complex conditions. The Nurse, Clinical Operations position is primarily responsible for supporting the clinical...