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WellSky is seeking a registered nurse to conduct telephonic patient evaluations for multiple payer programs, working on Pacific Time hours. The role emphasizes remote care coordination, schedule management, and collaborative protocol development.

Location: Fully remote. Description: Our client is seeking an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role, you will perform concurrent...

JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance Abuse...

Public Consulting Group in Oklahoma seeks a Client Success Partner for EDPlan Innovations – EDPlan Health. This role focuses on engaging client stakeholders, managing relationships, and delivering training on the EDPlan Health system for end...

Working remotely in a flexible environment, the Wisconsin Licensed RN Consultant will review prior authorization requests for Personal Care Services and Private Duty Nursing within Medicaid programs, ensuring compliance with state policies and...

Telephonic Nurse Case Manager: California RN License (Remote) Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To:...

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...

Remote Prior Authorization Reviewer Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a...

APremium Healthcare Solution, LLC is seeking a Virtual Nurse Consultant to provide remote nursing guidance and care coordination from a flexible, virtual setting in Conyers, GA. The role emphasizes high-quality patient outcomes and HIPAA-compliant...

UnitedHealth Group in El Paso, TX is seeking a Field RN Service Coordinator 1 – Case Manager to remotely support members with holistic assessments, care planning, and coordination across health and community services. The role emphasizes...

Summit provides independent insurance agents and their clients with market-leading workers' comp insurance and elite customer service. We're growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South,...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

CorVel Corporation seeks a Care Advocate Nurse for a remote role focused on assessing injury severity, reviewing medical data, and supporting the Claims Management department as a nurse consultant. The position requires clinical nursing...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

Eliot Community Human Services, Inc. is seeking a Nurse Manager to join the CBHC Child Team, providing leadership and clinical oversight for medical and psychiatric services. You will supervise nursing staff, coordinate care, and ensure...

OUR MISSION We exist to create a more connected, compassionate, and confident experience for people with cancer and those who care for them. We make it easier to get answers, access high-quality care quickly, and feel...

Utilization Management Nurse Consultant We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues...

Description We are hiring for a part- time School Nurse Consultant, come join our team! This is a non-benefited position that works on an as needed basis. See CESA 6 Values Here See details and apply on our website.

Utilization Review Specialist (RN) – Work From Home (Florida-Based Candidates Only)Concierge Home Care | Work From Home Opportunity – Must Reside in Florida At Concierge Home Care, we are growing and looking for an experienced...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

State of North Carolina is seeking a Nurse Consultant II (NS) in Immunization Branch. The role delivers expert clinical guidance, conducts VFC site visits, and advises health care providers and local departments. It requires NC RN licensure...

OverviewAs our Educator, RN in Periop, you will serve as a consultant/resource professional by providing staff development expertise as an educator, facilitator, change agent, leader, and researcher, ensuring educational initiatives are...

Humana, Inc. is seeking a Telephonic Registered Nurse Care Manager to support patients transitioning into and out of CenterWell Home Health services. You will collaborate with the clinical team to ensure appropriate post-acute care and...

Cambia Health seeks an Appeals Clinician I to evaluate member and provider appeals using nursing expertise and clinical judgment. This remote role supports multiple states and emphasizes medical policy, reimbursement guidelines, and compliance.

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...