Search Nursing Jobs

Qlarant is seeking a Nurse Specialist II to perform medical record and claims review for Medicare, Medicaid, and other claims data to ensure compliance and identify potential overpayment, fraud, waste, and abuse. This remote position allows work...

The McLaren system includes 12 hospitals across the state, ambulatory surgery centers, imaging centers, a 730-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 242,000 Michigan lives,...

HealthSnap is seeking a Nurse Care Navigator to support NY-based patients enrolled in chronic care management and remote patient monitoring. The role involves educating patients on hypertension, diabetes and other conditions, and coordinating with...

Humana seeks a Utilization Management Registered Nurse to interpret and support medical services coordination, documentation, and benefit determinations. You will work remotely, reporting to the Manager of Utilization Management as part of the One...

Duke University Hospital in Durham, NC is seeking an RN Operating Room Scheduler to coordinate daily OR scheduling with the perioperative team, collaborating with surgeon offices and nurse leaders to optimize patient flow. The role begins on-site...

Find your calling at Mercy! Serves as primary liaison between specialty physician and patient. Responsible for communicating with patients, assessing and evaluating their needs and advising the patients of the recommended actions/course of...

Utilization Management Nurse The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The role includes...

Cincinnati Children's is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department.

Baptist Health is seeking a remote Clinical Documentation Specialist to evaluate physician documentation and ensure accurate illness severity portrayal for coding precision. The role requires an active Kentucky license and involves guiding...

R1 is hiring a Customer Service Representative - Patient Registration for a remote PRN role in the United States. You will be the first point of contact for patients, ensuring fast, compassionate, and accurate access to care across multiple...

Astrana Health is seeking a Care Manager I - LPN to join Health Services. This remote role is based in the Maryland area and requires LVN/LPN licensure with utilization management experience. You will develop care plans, coordinate...

Arkansas Blue Cross Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and inpatient/outpatient procedures. The role requires an active RN license and a Bachelor's degree is...

About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo,...

Lehigh Valley Health Network, Inc. seeks an experienced RN for remote triage and healthcare navigation in Pennsylvania. The role provides telephonic triage to identify appropriate care levels, coordinates care across settings, and supports...

OhioHealth Corporation's Riverside Methodist Hospital seeks a Clinical Documentation Specialist for a full-time day shift. You will review inpatient records to accurately reflect severity of illness and risk of mortality, and collaborate with...

A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing...

Full-time Company Description WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare...

Cleveland Clinic is seeking an LPN Central Admissions role based in Independence, Ohio. This remote role includes on-site training at the Business Operations Center and a 9:00 am–5:30 pm weekday schedule, with weekends every 5th and two holidays...

RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued stays, and services, while coordinating with providers and payers to ensure compliance with...

Admissions Nurse Do you enjoy being at the beginning of the journey? The Admissions Nurse is responsible for establishing and maintaining positive relationships with customers and referral sources within the community. The Admissions RN...

Corrections Registered Nurse (RN)Setting: CorrectionsJob Type: TravelPay: $2400 / WeekHours:...

MEDLOGIX, LLC is seeking a Precertification Nurse-LPN/RN for a full-time remote position in NJ/PA. The role involves determining medical necessity for services related to Auto No-Fault injuries, with training to be conducted at the Hamilton, NJ...

Location: United States Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people,...

Praxis Health is seeking a Nurse Care Manager to coordinate patient care and promote evidence-based practices across Praxis Health clinics. The role focuses on reducing avoidable hospitalizations, improving patient outcomes, and enhancing...

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. The role focuses on reviewing inpatients with complex medical needs, coordinating with PCPs, facilities, and community resources to ensure...