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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,...

A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The...

Overview Provide clinical nursing expertise to support the training and evaluation of healthcare-focused AI systems. Review, annotate, and evaluate clinical data, including patient records and care scenarios. Translate real-world nursing...

Job OpportunitySeeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the opportunity...

A health care provider organization is seeking a Case Management Nurse to coordinate care for members. This role requires a Nursing Diploma and direct clinical experience, along with the current Michigan RN license. Responsibilities include...

Vaya Health seeks a Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical necessity. You will reference standardized criteria and coordinate with physician peers when needed. This role is part of a...

Northwell Health is seeking a Registered Nurse CDI Auditor to validate acute inpatient coded charts and ensure documentation substantiates diagnostic information. This remote position in New York requires a NY RN license, a BSN, and strong...

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

Broadway Ventures, a veteran-owned SDVOSB headquartered in Mississippi, seeks an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud referrals. You will apply clinical expertise...

Cambia Health Solutions is seeking a Remote Care Management Nurse to provide comprehensive clinical care management, including case management, for members in Idaho and surrounding states. Candidates must be Registered Nurses with a minimum of 3...

DaMar Staffing is seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. The role covers claims analysis, provider audits, fraud detection, and...

EMD Serono is seeking a RN Patient Support Specialist – West Coast to join the Patient Support Hub. This remote role delivers individualized clinical education, product training, and ongoing support to patients and caregivers, across multiple...

A prominent healthcare organization is seeking a Telephone Triage Nurse Line Advisor in Saint Paul, Minnesota. The role requires a current Minnesota RN License and 3+ years of RN work experience. You will independently triage patient calls and...

UnitedHealth Group is seeking an Inpatient Utilization Management Nurse, RN for a fully remote role serving the Sacramento area. The position requires 3+ years in acute care and 1+ year in utilization management, with certification in RN licensure...

A national healthcare recruiting firm is seeking an experienced RN Case Manager in Sacramento, CA. In this telephonic role, you will assess and coordinate care for high-risk members. The ideal candidate will have an RN license and at least two...

CareXM is hiring a Remote Registered Nurse (RN) for early morning triage on a part-time schedule. The role focuses on secure, compassionate after-hours triage for hospice and home health partners, conducted entirely from the nurse's home.

EMD Serono is seeking a Registered Nurse to join the Patient Support Hub as a remote RN, providing individualized clinical education and ongoing support to patients and caregivers for prescribed products. You will leverage nursing expertise and...

A leading healthcare provider in Columbia, Illinois is seeking an RN Supervisor for the Patient Access Center, focusing on evening shifts. The role demands strong clinical judgment and communication skills to optimize patient admissions and...

A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must...

Haven Home Health & Hospice is seeking a Quality Assurance RN (OASIS Certification Required) with COS-C or equivalent certification to review and ensure OASIS accuracy for patients in a fully remote Missouri-focused role. You will work with...

Chronic Care Manager (RN)Vitability Health of New Jersey Remote PositionOur MissionAt Vitability Health of New Jersey, we believe great care goes beyond checklists and charts—it's about relationships, trust, and walking alongside patients as...

Centene Corp. is hiring a Quality Improvement Coordinator II to conduct reviews of delegated entities for quality, service performance and utilization, and to lead clinical quality initiatives across provider sites. The role involves...

Chronic Care Manager (RN)Vitability Health of New Jersey Remote PositionOur MissionAt Vitability Health of New Jersey, we believe great care goes beyond checklists and charts—it's about relationships, trust, and walking alongside patients as...

A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and...