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Sentara Health Plans is hiring a Clinical Claims Reviewer RN for a remote role. The position is full-time, 40 hours, with standard hours 8am–5pm EST, Monday to Friday. Remote opportunities are available across many states, including New...

About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .

Comagine Health in Alabama is seeking Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective utilization reviews. This is a full-time remote role supporting...

Clinical Research Nurse I Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Guardian Life seeks an experienced RN Clinical Consultant to evaluate disability claims, analyze medical information, and provide clinical recommendations for claim decisions. You will collaborate with providers, claimants, and staff, ensuring...

JOB DESCRIPTION This RN will act as a Care Manager supporting our Michigan Medicaid members, identified with complex medical needs. The Medicaid Care Manager will support them to ensure a successful health outcomes. The position includes...

Utilization Management Nurse Consultant We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues...

Humana is seeking a Pre-Authorization Nurse to review and authorize care requests in a remote role based in Virginia or a compact-license state. You will evaluate medical necessity, coordinate with internal stakeholders, and educate providers on...

Utilization Management Nurse Consultant (RN) We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate...

Sanford Health Careers Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. Facility:...

Nurse Case Manager II - Illinois Position Type: Full-Time Contract Role Location: Fully Remote (Work from Home) Work Type: Work from Home Est. Pay Range: $30.00/Hour to $35.86/Hour on W2 (USD) Schedule: Mon - Fri 8:30 AM - 5:00 PM (3...

Womble Bond Dickinson (US) LLP seeks a Nurse Consultant to join our team. The Nurse Consultant provides high-level medical analysis and insight in support of legal matters, reviewing, interpreting, and synthesizing complex records into clear,...

Details Client Name Norris Healthcare Consultation Center HC3 Job Type Travel Offering Nursing Profession Nursing...

Lead Care Coordinator The Lead Care Coordinator will provide hands-on expertise to other team members as needed to help ensure that every patient receives the right type of care, at the right time in the right setting, every day. The Lead...

Job Description Join a team that's shaping the future of pediatric care. Children's Hospital Los Angeles is consistently ranked among the top 10 children's hospitals in the nation, delivering world-class care through more than 350...

Salary : $107,352.48 - $160,692.96 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: PH5230F-EA Department: PUBLIC HEALTH...

Aesthetic Registered Nurse $50/hr base + $5/hr weekend differential Fixed schedule No overnights You'll be the clinical expert patients trust to achieve results they didn't think were possible without surgery —...

Molina Healthcare is seeking a Medical Review Nurse (RN) to review documentation for medical necessity and appropriate levels of care, using clinical knowledge and utilization review expertise. This remote US role offers a full-time schedule.

Employment Type: Full time Description: Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices &...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Registered Nurse I Position allocable to RN I focus on applying recognized nursing principles/practices and developing nursing knowledge and skills while providing professional nursing care to patients in a variety of settings under close...

Job Title Day to Day Responsibilities Research and design treatment/care plans to promote quality of care, cost-effective health care services based on medical necessity complying with contract for each appropriate plan type.