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UBC in the United States is seeking a Clinical Case Manager to provide telephonic support for client funded contracts, reviewing payor criteria and performing clinical reviews for prior authorizations and appeals. The role builds...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Sylmar, California. Job Description & RequirementsSpecialty:...

MEDIKO is seeking a Corporate Nurse Educator to develop and oversee nursing education programs across the organization, ensuring staff competency and regulatory compliance. You will collaborate with clinical leadership to assess training...

American Traveler is hiring a remote RN for Utilization Management requiring an active MA RN license and prior utilization review and managed care experience. The role centers on fully remote utilization management with schedules...

Cascadia Healthcare is seeking an experienced PDPM Clinical Resource Nurse (RN or LPN) to support our skilled nursing facilities remotely. You will serve as a trusted resource for PDPM reimbursement, MDS coding, and CMS compliance, coaching teams...

Highmark Health is seeking a RN Care Coordinator to manage care transitions and coordinate with the care team. This hybrid, full-time role requires travel within PA and working with members wherever they are located. A BSN is required, with...

Job DescriptionJob Summary Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities...

Parkland Health is seeking a Licensed Vocational Nurse (LVN) to provide total nursing care for assigned patients under the supervision of a Registered Nurse. The role requires graduation from an accredited LVN program and current Texas LVN...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

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...

Comagine Health is seeking an RN to perform Clinical Review work and QIDP reviews. The team member will serve as the QIDP (.5 FTE) and as a nurse clinical reviewer (.5 FTE). The role requires applying Alabama Medicaid criteria to determine medical...

Sentara Health Plans is seeking a Care Coordinator- LPN to provide case management for Members in Nursing Facilities across Roanoke, Lynchburg and Danville areas. The role is remote from home with periodic travel to facilities; typical hours are...

Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides...

AccentCare is seeking a Regional Clinical Support Specialist IPC. The role supports hospice inpatient care programs with nursing teams across the Southeast region, emphasizing Florida and Georgia. This full-time, remote-friendly position requires...

VIVA HEALTH in Birmingham, AL is seeking a Case Manager, Utilization Review to support members and high-risk patients. The role involves coordinating utilization review activities, performing timely medical records checks, and determining medical...

Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

Centene Corporation seeks an experienced Registered Nurse to join our remote care management team for New Jersey. You will develop and coordinate complex care plans, assess needs, and work with providers to improve outcomes across the member...

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...

ProPharma Group is seeking a Registered Nurse to support clinical research visits conducted outside investigator sites. You will collect data, ensure patient safety, and collaborate with leadership to implement nursing practices in study...

See Your Work in a New Light At LUX Infusion, we're reimagining infusion care to be more human, supportive, and connected. Inspired by lux—meaning light - we guide patients, providers, and partners through complex therapies with...

To support a dynamic team, the full-time Clinical Quality Assurance Coordinator will ensure the quality and integrity of peer review case reports while working remotely, adhering to client agreements and regulatory standards.Key...

Humana is seeking an experienced Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care teams, including SNF, home health, and DME. You will work remotely with occasional...

Adjunct Faculty Pool - Clinical Nursing (All Areas)Please see Special Instructions for more details. Posting Summary Working Title Working Title Adjunct Faculty Pool - Clinical Nursing (All Areas) Role...

Solventum is seeking an Advanced Wound Care Regional Sales Manager for the Remote-Kansas City, MO area. The role leads a sales team focused on customer support, growth and key relationships, with travel up to 50%. A Bachelor's degree (or higher)...