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Capitol Bridge LLC is seeking a Claims Review Nurse to support the Florida Statewide Health Plan CDR program and other state IRO programs. The role involves assessing documentation, coordinating with clinical reviewers, and drafting determinations...

Sentara Health Plans seeks an RN Clinician to perform utilization management and claim reviews across inpatient and outpatient settings. The role supports pre/post payment reviews and authorization assessments, ensuring compliance with policy and...

IQVIA is seeking a Flex Nurse Educator to deliver remote patient education and in-field support during territory vacancies, supporting adherence and disease management. This is a non-clinical, educational role requiring an active RN...

Sedgwick is seeking a Utilization Review RN for a telecommuter role in Michigan. You will review treatment plans, analyze medical records, and determine appropriate care using evidence-based criteria within a collaborative environment.

Netsmart is seeking a registered nurse to perform utilization review for emergency department admissions and ongoing stay reviews. You will evaluate EMRs, apply InterQual/MCG criteria, and collaborate with ED physicians to determine admission...

UCSF Health Medical Foundation is seeking an experienced Primary Care Telephone Triage Registered Nurse to work remotely from home. The role requires a California RN license, at least two years of full-time triage or acute care RN experience, and...

U.S. Army Family Nurse Practitioners perform the highest level of quality care for Army Soldiers, retirees, and their families. If you are looking to combine your skills as a family nurse practitioner and your passion for...

Alignment Health is seeking an inpatient review nurse to join our remote utilization management team. The nurse will collaborate with the patient's PCP, facility case manager, discharge planner, and contracted providers to ensure appropriate,...

Humana is seeking a Behavioral Health Prior Authorization Nurse to join the Wisconsin Medicaid Market (iCare) team. This role involves reviewing the clinical appropriateness of prior authorization requests to ensure they meet medical necessity and...

CVS Health is hiring a full-time RN for healthcare services and utilization management. The role emphasizes assessing and coordinating care, applying clinical criteria, and communicating with providers to optimize member outcomes. The...

START Research's START Center for Cancer Research in Los Angeles is seeking a Clinical Research Coordinator, RN to support early-phase oncology trials. The role involves direct patient interaction, data collection, and ensuring protocol compliance...

Clinic Nurse The START Center for Cancer Research ("START") is the world's largest early phase site network, fully dedicated to oncology clinical research. Throughout our history, START has provided hope to cancer patients in global...

TEEMA is seeking an RN with 3+ years of clinical experience for a remote role in the United States. The position emphasizes medical record review, quality assurance, and collaboration with medical leadership. The role requires strong...

Cedars-Sinai in Los Angeles is seeking a Virtual Care Nurse Per Diem to join a remote patient care team. You will coordinate triage, care planning, and education across disciplines to ensure safe, timely, and quality care. Required: RN with...

Family Service of Rhode Island (FSRI) seeks a per diem School Nurse to join our multidisciplinary team in Exeter, RI. The nurse provides healthcare services to students and staff, manages health needs, responds to emergencies, and supports...

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...

CLINICAL DOCUMENTATION SPEC III PRN - REMOTE Camden, NJ Job ID 73418 Job Type Per Diem Shift Day Specialty Other Professional About us Cooper Norcross Health, formerly Cooper University Health Care, is...

To support a specialized endoscopy clinic, the remote Minnesota Licensed RN Specialist will assess patient needs, implement nursing interventions, and evaluate care outcomes while coordinating with healthcare team members.Key...

TriHealth is seeking a Clinical Documentation Specialist RN to review inpatient records, ensuring accuracy of diagnoses, severity of illness and quality measures. You will educate physicians and nurses, collaborate with coding staff, and drive...

Baptist Health is seeking a remote Clinical Documentation Specialist to evaluate physician documentation and ensure accurate illness severity portrayal for coding precision. The role requires an active Kentucky license and involves guiding...

Job ID: 33022 Description Take on a key role within an award-winning health system. Help improve patient experiences as part of a world-class healthcare team. Take your career in an exciting new direction. You can...

Trillium Health Resources is seeking a Population Health Nurse to provide clinical care management and population health support for assigned members, focusing on prevention, wellness, and outcomes. The role uses nursing judgment as an RN to...

Oregon Department of Corrections is seeking an experienced Institution Registered Nurse for a limited-duration role based in Salem, OR, with remote work options. The RN will review medical records, assess care adequacy, and coordinate services...

Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong...

Responsibilities Plans, implements, coordinates, and evaluates comprehensive care for designated patients to ensure quality of care and continuity of care delivery through telehealth platforms. QualificationsMinimum...