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MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare...

Oscar Health is seeking a Utilization Review Nurse to join our team. You will review cases, verify medical records, and consult with care providers to assess treatment appropriateness using Oscar Clinical Guidelines, MCG, and InterQual. The...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and...

Resp & Qualifications We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for...

Position Summary Monitors the admissions, continued stay, and discharge of patients following pre-established criteria. Assures that patients meet MCG criteria from admission to discharge including appropriateness of level of care. Conducts...

Indiana University Health Metro Region is seeking a PRN Psychiatric Nurse Practitioner or Psychiatric Physician Assistant to join our Virtual Care Behavioral Health team. This remote role provides virtual consults across Indiana's emergency...

Registered Nurse (RN) - Home Infusion Therapy AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity.

The Registered Nurse (RN) is responsible for preparing the patient for surgery and providing post-operative care after surgery. ESSENTIAL FUNCTIONS: To perform this job successfully, an individual must be able to...

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...

Clinical Appeals Nurse We are seeking an experienced Clinical Appeals Nurse to support the appeal and grievance processes by analyzing and responding to adverse coverage decisions. This role involves clinical judgment, regulatory...

Spectraforce Technologies is seeking a Quality Audit Specialist (RN) for a remote 6-month assignment. The role focuses on abstraction of medical records for HEDIS, with accurate data entry into healthplans databases. The ideal candidate...

Healthcare Provider Solutions is seeking a full-time remote Clinical Consultant to join our clinical consulting team. The ideal candidate has at least 2 years of hospice quality assurance/compliance experience and RN or therapist licensure.

JOB DESCRIPTION Job Summary Provides 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...

Trinity Health is seeking a Nursing Support (NS) colleague to provide safe, quality health care services under the supervision of a registered nurse or designated professional. The role may involve licensed or unlicensed bedside care and...

Job Description Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally for excellence in cancer treatment,...

Cabell Huntington Hospital is seeking a casual, as needed Virtual Integrated Care Coordinator (RN) for our CHH Virtual Integrated Care Department. This job is responsible for supporting and...

Job Description: To show our commitment to you and to assist with your transition into our organization, we will also offer a $ 20,000 sign-on bonus for experienced RNs night-shift only. The Registered Nurse (RN) is a professional caregiver who...

Guidehealth is seeking a remote RN Case Manager with an Illinois nursing license to enhance member management, satisfaction, and cost effectiveness. You will support wellness, coordinate care, and navigate the healthcare system as part of the...

Join to apply for the Case Manager (LVN or RN) role at Astrana HealthLocation: 1600 Corporate Center Dr., Monterey Park, CA 91754Compensation: $31.00 - $45.00 / hourDepartment: HS - ICMAstrana is looking for a RN/LVN Case Manager and we are...

Case Management Nurse Provides excellent patient care by assisting in the collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, physicians,...

Public Health Nurse The County of Los Angeles Department of Public Health is seeking qualified candidates to fill emergency Public Health Nurse vacancies related to the homelessness crisis. Under the emergency order, applicants who...

Utilization Review Nurse Auditor Fully Remote • Mount Laurel, NJ 08054 Salary Range $33.00 - $46.00 Hourly Position Type Full Time Travel Percentage 10% ExamWorks is looking for a Utilization Review Nurse Auditor to join...

PruittHealth Position This position is primarily remote with limited in home visits. Job Purpose: Responsible for the oversight of clinical care management of community based long-term care population for PruittHealth...

NK Consultancy LLC is seeking an experienced Nurse Case Management Trainer to help build a new training program within our Operations Support team. The role blends field nursing expertise with leadership and curriculum development. You'll...

Kaiser Permanente in Downey, CA is seeking a Case Management Utilization RN for a full-time, day-shift role. The position emphasizes coordination with physicians and the multi-disciplinary team to plan, assess, and evaluate patient care and...