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Molina Healthcare is seeking a Wisconsin-licensed RN for a remote IRIS Self-Directed Personal Care (SDPC) role. You will oversee a group of IRIS participants, assess needs, and educate providers and participants in their homes and communities.

Palmetto GBA, LLC, a BlueCross BlueShield subsidiary, seeks an RN reviewer to conduct medical claim reviews from a home office. You will assess medical necessity and ensure adherence to established criteria, while supporting staff with guidance...

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...

Elevance Health is seeking a HEDIS Medical Record Review Project Nurse to support HEDIS data abstraction and quality review in a fully virtual role with occasional in-person training. The position requires residing in Florida, a BSN, and at least...

Allina Health is seeking a Nurse Informaticist to join the Information Systems Optimization Solutions team. The role focuses on integrating nursing practice with data science to improve patient outcomes and care quality across inpatient and...

Position: Clinical Professionals: Paid Study on Healthcare Software Workflows Type: Hourly Contract Compensation: $60/hr Location: Remote Role Responsibilities Navigate a...

ExamWorks is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator. This 100% remote role focuses on QA of peer review reports, ensuring accuracy, clinical citations, and adherence to client specifications and...

Cambia Health is seeking an Appeals Clinician I to work remotely from home within Oregon, Washington, Idaho or Utah. You will apply nursing expertise to complete the clinical component of all appeal types, resolving member and provider appeals...

Integra Partners seeks an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a NCQA-compliant UM program. The role collaborates with the Medical Director to assess medical necessity and benefit coverage...

Registered Nurse Navigator - Cancer Center Exams - 10 Hour Days Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally...

CVS Health is seeking a Nurse Consultant for a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient and outpatient services, authorize care, and escalate cases as needed, while coordinating 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...

Medlogix, LLC in Hamilton, NJ seeks a Quality Assurance Nurse for a hybrid role, combining remote work with occasional in-office days. The position involves reviewing IME and peer review reports, ensuring accuracy, consistency, and adherence to...

Masimo is seeking a Clinical Research Lab RN to join our team in Irvine, CA. You will perform venous sampling, IV placement, and arterial-line tasks while supporting R&D funding, regulatory filings, and marketing initiatives for Masimo products.

River Valley Child Development Services Inc seeks a Child Care Nurse Health Consultant to provide technical assistance and develop trainings on health, safety, and nutrition for childcare providers in WV. This exempt, full-time role offers remote...

Health Care Service Corporation is hiring a Nurse Liaison I for Utilization Management & Quality Review. This remote nationwide role supports clinical review activities, benefit determinations and medical necessity assessments, ensuring compliant,...

Centene is seeking a remote Utilization Review Nurse to perform concurrent reviews, determine appropriate levels of care, and support discharge planning for inpatient services. You will collaborate with Medical Affairs and care teams to ensure...

A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities...

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...

Job ID: 33628 Description Join UCLA Health's Nuclear Medicine team and play a critical role in delivering cutting-edge diagnostic and therapeutic services to both adult and pediatric patients. As a Registered Nurse...

Novitas Solutions, Inc. seeks a Clinical Review Nurse to review and substantiate medical determinations for health claims. You will assess medical necessity, service levels, and appropriateness of care under national and local policies,...

HealthEdge in the United States seeks a Telephonic Utilization Management RN for Behavioral Health to coordinate care and perform medical necessity reviews across inpatient, outpatient, and ancillary services. Coordinate care through the health...

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

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...

Harborview Medical Center invites applications for a Tele Forensic Nurse Examiner (TFE) within the FNE/SANE program. The role is fully remote, with nurses working from home and periodic remote team meetings. The position requires WA RN...