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Exceptional care starts with exceptional people. For us, this is more than a job- it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to...

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...

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...

Humana is seeking a Behavioral Health Prior Authorization Nurse to join the Wisconsin Medicaid Market (iCare) team. This role involves reviewing the clinical appropriateness of prior authorization requests to ensure they meet medical necessity and...

Optum is seeking a remote IRR Clinical Claim Review Nurse to perform clinical review of claims against medical records and guidelines. The role requires an active RN license, 2+ years of acute care clinical experience, and 1+ year in claim review...

OU Health seeks an experienced Utilization Review Nurse (RN) to support the Children's Behavioral Health Center. The role involves evaluating medical necessity, coordinating with Payors, and ensuring appropriate hospital stay authorizations after...

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...

Job Title Starting Pay Range $3,211.53 - $3,721.15 - Bi-Weekly Depending on experience Job Description Essential Functions include, but are not limited to the following: Assess the health and...

Valeris is hiring a Patient Support Nurse to engage program patients from enrollment through treatment, helping them initiate and complete therapy successfully. The role requires active RN licensure, 2–3 years of nursing experience, and...

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...

Job Summary and ResponsibilitiesAs our Educator in Critical Care Emergency, In accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a consultant/resource...

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...

Float Health is seeking an Intake Specialist to manage new patient referrals and coordinate start-of-care visits. This externally facing role requires quick action, clear communication, and meticulous attention to detail to ensure timely,...

POSITION SUMMARY Reporting to the Director, Ambulatory Services of Martin Luther King, Jr. Los Angeles (MLK-LA) Healthcare Corporation, the Ambulatory Clinical RN as the leader of the health care team, provides professional...

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...

Actalent is seeking a dedicated Medical Device Safety Reviewer to collect, review, assess, and process complaints and reports related to medical device adverse events and device deficiencies in clinical studies. This contract position is fully...

Palmetto GBA, LLC, a BlueCross BlueShield subsidiary, seeks an RN reviewer to conduct medical claim reviews from a home office. You will assess medical necessity and ensure adherence to established criteria, while supporting staff with guidance...

Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. The nurse will collaborate with the patient's PCP, facility case manager, discharge planner, and contracted providers to ensure appropriate,...

Clinical Nurse III - Observation Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope's growing...

Effizotech is looking for a dedicated Patient Care Coordinator to join their team. This role involves coordinating patient appointments for infusion services while ensuring timely communication with patients. The opportunity offers the flexibility...

CSI Pharmacy, LLC seeks a Regulatory and Compliance Nurse to implement and maintain the nursing employee health program across states, ensuring TB screening, immunization tracking, disease monitoring, and recordkeeping meet regulatory standards.

Registered Nurse Thank you for considering a career at Mercy Health! Scheduled Weekly Hours: 40 Work Shift: Days/Afternoons (United States of America) Join our team today! Higher Pay Scales and Sign-On...

Comagine Health in Washington State is seeking an experienced Registered Nurse to join our remote Clinical Reviewer team. The role focuses on assessing medical necessity, appropriateness, and quality of care through prospective, concurrent, and...

Registered Nurse Long Beach, CA 90813 Overview Salary Range $47.00 - $56.40 Hourly Level Experienced Position Type Part Time Job Shift Day Description The Registered Nurse (RN) works under the direction of...

Brighton Health Plan Solutions is seeking an experienced Utilization Management Nurse to perform medical necessity and benefit reviews remotely, supporting both inpatient and outpatient cases. The role requires an active LPN license, strong...