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The Veterans Health Administration in East Orange, NJ seeks a Registered Nurse to serve as Community Care Coordinator. You will coordinate care across VA and community providers and guide Veterans through their care options.

Medix™ is seeking a clinically strong, detail-oriented Registered Nurse to join our Utilization Review team in a fully remote role. You will conduct medical necessity reviews, determine appropriate patient status, and collaborate with physicians...

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental...

Amerit Consulting represents a Global Fortune 50 client seeking an Oncology Registered Nurse – Clinical Data Abstractor for a remote, 3-month assignment. You will perform electronic medical record abstraction, review oncology charts, and input...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...

Compass Healthcare Consulting & Placement is conducting a search for an experienced MLTC Intake RN with UAS-NY experience for a Managed Care Plan servicing New York. Intake Assessments / Enrollments are Field & Remote Assessments working directly...

Valeris, a life sciences commercialization partner, seeks a Patient Support Nurse to facilitate patient journeys on therapy. You will educate patients, caregivers, and healthcare providers in a telephonic setting, addressing insurance coverage,...

Highpoint Health Sumner is seeking a Registered Nurse (RN) Clinical Documentation Specialist to join as a remote FT (days). You'll contribute by applying plan-of-care interventions and driving patient-care innovations with advanced technology.

Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity Are you an experienced RN with a background in acute care and utilization management? Join our team...

OpTech is seeking a Registered Nurse (RN) to support utilization review and clinical review activities for a Michigan health plan. This role involves evaluating medical services for medical necessity, level of care, and clinical criteria. The...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Comprehensive Rehab Consultants (CRC) seeks an LPN/LVN Care Coordinator for a 100% remote role serving geriatric post-acute patients. You will review EMR data, develop care plans, and coordinate with providers and caregivers to support patient...

Nurse Consultant/ Regional Director Of Clinical Operations Relocation to Southern New Mexico is required. The Nurse Consultant/ Regional Director of Clinical Operations position is comprised of two essential objectives; to partner...

Iris Telehealth is hiring PMHNPs for 100% remote consult-liaison telepsychiatry in Texas. Earn $120/hr with a sign-on bonus, working 13–16 overnight shifts per month, including weekends. Roles require Texas PMHNP licensure, 2 years...

Cincinnati Children's is seeking a registered nurse to join the After Hours Nurse Helpline on a remote, full-time schedule with rotating weekends and holidays. The role supports patient care when offices are closed and requires adaptation to a...

National Care Advisors is seeking a Nurse Case Manager in the DC/Baltimore area to coordinate case management for eldercare clients, working with families, attorneys, and trustees to support quality of life. The role emphasizes timely...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

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...

GeBBS Consulting is seeking experienced Medical Record Retrievers/Clinical Record Reviewers to support HEDIS retrospective projects. You will retrieve, abstract, and perform over-reads of medical records via fax, email, or phone, with some onsite...

*This role will require the successful candidate to work the shift of Monday to Friday, 1pm to 10pm Central (2pm to 11pm Eastern). The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This...

Steadfast Health is hiring a Float APP to provide addiction medicine care across inpatient consults and outpatient programs. The role is virtual-first with Nashville-area in-person coverage when needed, supporting transitions to Steadfast clinics...

We are seeking a Locums Psychiatric Clinic Lead Nurse Practitioner (PMHNP) to provide behavioral health care through telehealth across New York. This role provides psychiatric assessment, medication management, behavioral health consultation, and...

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...

Float Health is seeking an Intake Specialist to manage new patient referrals and coordinate start-of-care visits. This externally facing role requires quick action, clear communication, and meticulous attention to detail to ensure timely,...

Claims Medical Review Nursing Consultant Job No: 544045 Work Type: Full-time Location: REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX Categories: Healthcare/Medical Support Level,...