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Optum NV is seeking an RN Case Manager Telephone Advice Nurse to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll...

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...

Spectrum Healthcare Solutions in Oklahoma City is seeking a Nurse Liaison (LPN / Medical Assistant) to coordinate services across long-term care, skilled nursing, inpatient rehab and assisted living facilities. The role focuses on bridging...

VHC Health in Arlington, VA is seeking a Virtual Nurse/Nursing Care Partner to provide indirect nursing care to assigned patients across inpatient units via remote technology. The role supports admissions, education and discharge planning with...

CNA - AM/PM & NOCMy clients are looking for certified nursing assistants to fill vacancies during our AM and PM shifts. We are looking for dynamic applicants who would like to combine their love for people and strong work ethic with the...

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...

Performance Home Health is seeking an experienced Referral Review Nurse to join our growing team. This role reviews incoming home health referrals, ensures complete documentation, identifies missing information, and coordinates with multiple...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient and outpatient services, collaborate with providers to authorize care, and...

HBiz seeks a Clinical Appeals Nurse (RN) to remotely support revenue cycle operations. You will review denied claims for clinical accuracy, develop evidence-based appeal strategies, and draft payer-ready documentation to overturn denials and...

Prolific seeks Registered Nurses to join its AI training and evaluation program in the United States. If you hold a current nursing license and clinical experience, you can help train AI models by rating scenarios and providing feedback.

Effizotech is looking for a dedicated Patient Care Coordinator to join their team. This role involves coordinating patient appointments for infusion services while ensuring timely communication with patients. The opportunity offers the flexibility...

MEDLOGIX, LLC is seeking a Precertification Nurse-LPN/RN for a full-time remote position in NJ/PA. The role involves determining medical necessity for services related to Auto No-Fault injuries, with training to be conducted at the Hamilton, NJ...

Centene Corporation in the United States is seeking a Nursing professional to analyze prior authorization requests and determine medical necessity and level of care in line with standards and coverage. You will collaborate with medical teams to...

Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health...

Facilitates the provision of timely and effective patient care under the supervision of licensed members of the healthcare team. Helps maintain a safe and clean environment in order to enhance department operations. Patient care is delivered...

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...

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...

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...

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...

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...

Work From Home Nurse Practitioner (PMHNP - Telehealth - Flexible Schedule)Join to apply for the Work From Home Nurse Practitioner (PMHNP - Telehealth - Flexible Schedule) role at NPHireBase pay range$175,000.00/yr - $200,000.00/yrAbout the RoleA...

Job Category: Clinical Services Nursing Requisition Number: CERTI003229 Posted : September 15, 2026 Part-Time On-site Locations Showing 1 location ...

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...

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,...

Spectrumforce Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for a 3-month contract to hire. The role is remote with work location listed as Remote-MS CST, schedule 8 am-5 pm Central time, with occasional weekend...