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Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

At Houston Methodist, the Nurse Practitioner (NP) is responsible for functioning as a licensed registered nurse and care provider to provide all aspects of patient care, including diagnosis, treatment and consultation while maintaining and...

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform both inpatient and outpatient...

Description Position Description: Telehealth RN Location: Remote (Telehealth) - Must hold an active Pennsylvania RN license Schedule: Daytime hours, Monday-Friday (normal business hours) Compensation:...

Description LifeHealth, LLC, a federal government contractor, is seeking Registered Nurses to provide telephonic Nurse Advice Line services to Soldiers, Veterans, Wounded Warriors and their families, who are TRICARE members.

*Job Summary and Responsibilities* As our Clinical Nurse, you will be a central figure in our patient care team, delivering exceptional, compassionate care that truly makes a difference in our patients' lives. Every day you will collaborate...

Compassus is seeking a Hospice RN Clinical Coordinator to oversee administrative and management functions in the absence of the Director of Clinical Services. May carry caseload and ensure compliance with state and federal regulations. Remote role...

Renown Health is seeking a Utilization Management RN to apply medical necessity criteria for prospective and concurrent reviews. You will work with an interdisciplinary team to ensure medically necessary, cost-effective care at the appropriate...

About the Role: Our client, a leading telehealth platform, is expanding rapidly and looking for a dedicated Nurse Practitioner to join their virtual care team. You will provide exceptional primary care services to a diverse patient...

Nurse Practitioner (DOM Occupational Health) The Division of Occupational and Environmental Medicine is seeking a Nurse Practitioner to manage clinical and administrative coverage at the Latham & Watkins on-site clinic in Los Angeles,...

JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory...

Guidehealth is a fully remote organization seeking a Care Manager to guide patients and families through complex health journeys from a Louisiana base. You will combine clinical expertise with holistic care, coordinating medical, behavioral, and...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Job DescriptionMake a Difference Every Single Day at Cedars-Sinai!When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of passion and...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding...

CenterWell Home Health is seeking a Telephonic Nurse (Care Manager) to support patients transitioning into and out of our services. You will liaise with the clinical team to facilitate follow-up and ensure appropriate post-acute care options,...

Peraton's SafeGuard Services is seeking a Nurse Reviewer to perform medical record reviews and apply clinical judgment to determine claim payment decisions. The role involves researching claims data, identifying issues, and developing cases for...

Performs an age specific plan of care for a designated group of patients using the nursing process of assessment, diagnosis, outcome identification, planning, implementation and evaluation of patient care. Collaborates with physicians and other...

Utilization Management RN (Illinois) Position Type Full-Time Job Shift Day Education Level Bachelor's Degree Category Nursing Professional & Support Centurion is proud to be the provider of comprehensive services to the Illinois...

MCMC is seeking an RN/LPN/LVN with a clinical background to join as a Clinical Quality Assurance Coordinator, performing QA reviews of peer reports from home. You will ensure evidence-based rationales, accurate client instructions, and standards...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

Care Management Coordinator/RNLocation: 100% Remote Duration: 3+ Months (FT conversion)This is a Utilization Management RN part time position - working every other weekend (2 days a week in a 2 week cycle). Must be available M-F 8:30-4:30pm for...

Registered Nurse (RN) – Remote Care Management & Coordination Location: remote Job type: Contract Job Summary: The Registered Nurse (RN) plays a critical role in delivering remote patient support, care management, and care...

CareHarmony is seeking a licensed practical nurse to join as a remote Intake Coordinator in a full‑time role. The position supports value-based care management by coordinating resources for patients and conducting preliminary health assessments...

Crawford & Company is seeking an experienced RN Telephonic Case Manager to work remotely providing case management services for patients and employees. You will navigate their healthcare journeys, align with URAC standards, CMSA Standards of...