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Aetna in Providence, RI is seeking a qualified Registered Nurse to support clinic operations and patient care. You will perform clinical duties, participate in phlebotomy, vaccinations, vitals, and diagnostic assessments while ensuring...

Stormont-Vail HealthCare, Inc. is seeking a full-time Registered Nurse for the First Shift (Days) to provide professional nursing care to clinic patients in Topeka, KS. The role follows established practices and emphasizes compassionate care...

Greenlife Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical studies. With a...

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...

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...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

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...

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...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

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...

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 recruiting agency is seeking a Licensed Practical Nurse for a remote position in Providence, Rhode Island. The ideal candidate will have at least 2 years of clinical experience and be responsible for processing and communicating Commercial Prior...

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...

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.

A healthcare company is seeking a Tele-Health Registered Nurse to join their Specialty Pharmacy team in Irving, Texas. This role involves counseling patients on specialty drug therapies and ensuring adherence to treatment protocols. Successful...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Labor & Delivery Metro Denver Women and Infants (W&I) Float Pool RNs will support patients and teams at Highlands Ranch Hospital, Longs Peak Hospital, and University...

A leading healthcare company is seeking an experienced Telephonic Nurse Case Manager to manage medical claims and facilitate care for injured workers. The ideal candidate will have at least a year of experience in Florida Workers' Compensation,...

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: SSM is looking for an experienced nurse with Hospice/...

Job Description: The Nurse Clinical Leader provides leadership and clinical expertise during their shift and within their department. They manage unit resources and supervise personnel to ensure appropriate staffing levels based on the unique...

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the...

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...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

The Gardens at Country in Swansea, MA is seeking an experienced MDS LPN for a full-time remote role. You will perform MDS assessments, review records, and collaborate with nursing and interdisciplinary teams to ensure high-quality resident care.

The Triage Registered Nurse is responsible for identifying and coordinating patient/family needs and for providing preventive and supportive care to the terminally ill patient/family unit. The Triage Registered Nurse provides continuity of care to...

Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to...