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We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

Clinical Review Nurse Duals Program Details- Brand new program of 2026 for Centene Duals = Medicare + Medicaid line of business. Members have one combined card and one authorization covering both benefit types. The duals...

Admissions Nurse Salary Range: $48 - $51 / Hourly Job Description Why Hospice? Why VITAS? Have you ever considered hospice as a clinical specialty—one that blends clinical expertise with deep human connection?

Job Description: Participates in the development and ongoing implementation of QM Work Plan activities. Improve quality products and services, by using measurement and analysis to process, evaluate and make...

Overview The Legacy/OHSU Interventional Radiology practice provides services at four locations (EMC, GSMC, MHMC and MPMC) including ambulatory clinics at each site. The IR team cares for both adult and pediatric patients with...

ResPro Health is dedicated to providing our partners in the respiratory space with the tools and resources needed to implement meaningful programs like remote patient monitoring and chronic care management in their pulmonary practices. With a...

Ssbv Clinical Claims Review Rn 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...

Build your own schedule. Take control of your career. Looking for CNA jobs that fit your life? If you're tired of having no control over your schedule or just want to earn more money, PRN shifts could be what you're looking for! ShiftKey...

Your Future Role At A Glance Location: Remote - Must be within 1 hour of Milwaukee, WI Department: Transfer Center Schedule: Night shift | 7pm - 7am | Full Time Salary: $40.41 - $57.05 (per hour) Life At...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Exempt Hiring Range:...

Job Title Utilizes a collaborative review process of benefits, minimally necessary clinical information and evidence-based clinical guidelines to formulate decisions regarding medical necessity, pre-existing conditions, benefits and/or...

Join Our Team as an Infusion Registered Nurse in Santa Monica, California! Infusion for Health is a premier, referral-based infusion center serving patients across California, Arizona, Nevada, Washington, Colorado, and Missouri. Our...

LVN Charge Nurse (Licensed Vocational Nurse) LVN Charge Nurse (Licensed Vocational Nurse) Qualifications • Graduate of an accredited school of nursing or an approved LVN program. • Current nursing licensure in the state...

Setting: Outpatient Clinic / Ambulatory Care Schedule: Full-Time | Day Shifts (Typically No Nights) About the Opportunity We are seeking a Registered Nurse (RN)...

JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

Clinical Review Nurse - Remote ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a...

Utilization Review Nurse Health Plans - Case Management US:NM:Alamogordo | Utilization Management | Full Time This position has a remote option for those living close and will be able to come into the hospital as needed.

Ocean State Job Lot is seeking an RN for Utilization Management in Los Angeles, CA. This role involves coordinating care submissions and documentation for patient admissions, focusing on high-quality care and efficiency. Candidates must hold an...

Clinical Appeals RN 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...

Overview Sign on bonus available to qualified candidates. Responsibilities Performs a variety of patient care activities in accordance with established standards and practices.

Clinical Review Clinician 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...

Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We...

Utilization Review Rn 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...