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It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

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.

Remote Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set...

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...

Job Title Pay Rate: $27.50 per hour Work Mode: Fully Remote Duration: September to February with possible extension Responsibilities: Work telephonically with claimants, physicians, employers, and customers to ensure...

Job ID: 33380 *Description*There's nothing more exciting and rewarding than being able to make a significant, positive difference in someone's life. At UCLA Health, you'll experience this joy every day while also enjoying the positive,...

Healthcare Executive Placements, Inc. (HCEPInc.) is seeking an InterimRN Quality & Safety Improvement Consultant for a 13-week W2 contract in Baldwin Park, CA. The role focuses on clinical quality, patient safety, regulatory readiness, and...

Job Summary The Supervisor Nurse Specialty role, is responsible for leading and overseeing a network of contracted nursing agencies supporting home-based and specialty pharmacy services. This role manages nursing contracts and agency...

Job Opportunity At The Samuel Oschin Cancer CenterDo 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...

Cunningham Children's Home in Urbana, IL, is seeking a Nurse Case Manager to support youth with emotional, psychological, and physical care in residential programs. You will provide medical case management, screening, education, counseling, and...

Physicians East seeks a QEC Pre Procedure Screening Nurse for a part-time remote role based in Greenville, NC. The nurse will review patient charts, screen for procedural eligibility, and coordinate with physicians to ensure proper evaluation and...

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 who care deeply, innovate with purpose, hold...

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...

BlueCare | Clinical Nurse Consultant | Community Care Employment Status: Full time - 6 Month Fixed Term Contract Location: Network A scope – Remote Support, some travel across Network may be required (North QLD - Mackay to...

Job Description Utilization Review RN - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the...

Are you looking for an exciting way to utilize your nursing skills and expertise to deliver quality nursing care in a remote setting? AccessNurse, where technology meets compassionate care, is looking for professional nurses & offering...

Evaluating clinical requests to determine medical appropriateness, the full-time Washington Licensed Utilization Review Nurse will conduct medical necessity reviews, consult with Medical Directors, and collaborate with various teams while working...

Moda Health is hiring for a Care Coordination professional to ensure timely, appropriate care within policy guidelines. You will interact with members, families, and providers to develop and monitor treatment plans. The role is a full-time,...

State of Washington's Nursing Consultant role conducts investigations and inspections for Region 1C to ensure long-term care providers meet WAC and RCW requirements. This highly independent position manages a worklist, travels to facilities, and...

Sedgwick is hiring for a Clinical Consultation Triage Nurse in a remote, full-time role. You will triage calls, assess needs, and provide care guidance to determine the appropriate level of care, while supporting return-to-work goals. The...

56512 Job Description Join a team that's shaping the future of pediatric care. Childrens Hospital Los Angeles is consistently ranked among the top 10 children's hospitals in the nation, delivering world-class care through more...

JOB DESCRIPTION This RN will act as a Care Manager supporting our Michigan Medicaid members, identified with complex medical needs. The Medicaid Care Manager will support them to ensure a successful health outcomes. The position includes...

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 who care deeply, innovate with purpose, hold...

Appeals 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 who care...