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ExamWorks is seeking a Utilization Review Nurse Auditor to perform quality utilization reviews and authorize medically necessary care. The role is fully remote with standard EST hours, requiring an active nursing license and coding certification.

American Health Plans in Franklin, TN is seeking a Utilization Review Nurse to assess medical necessity and quality of care across pre-service, concurrent, and retrospective reviews. You will support the Clinical Services Department and Medical...

Telenett is seeking a Remote Patient Monitoring Nurse to provide home-based telehealth care. The role involves monitoring patients remotely, performing virtual assessments, and educating on disease and medication management. You will...

CVS Health is hiring a full-time RN for healthcare services and utilization management. The role emphasizes assessing and coordinating care, applying clinical criteria, and communicating with providers to optimize member outcomes. The...

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...

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will assist patients through the continuum of care in collaboration with the patient's primary care physician, facility case manager,...

IQVIA is seeking a Flex Nurse Educator to deliver remote patient education and in-field support during territory vacancies, supporting adherence and disease management. This is a non-clinical, educational role requiring an active RN...

Baptist Health in Jacksonville, FL, is seeking a Registered Nurse for its Hospital At Home program. You will educate patients and families, advocate for patient needs, and coordinate care across medical and nursing teams in a home-based setting.

TriHealth is seeking a Clinical Documentation Specialist RN to review inpatient records, ensuring accuracy of diagnoses, severity of illness and quality measures. You will educate physicians and nurses, collaborate with coding staff, and drive...

Tennova Healthcare- Turkey Creek Medical Center is seeking a PRN Remote Clinical Utilization Review Specialist to evaluate the necessity and efficiency of hospital services and to support payer requirements. You will review admissions and...

LifeBridge Health's Sinai Hospital Utilization Review team is seeking a remote, full-time RN to conduct initial, concurrent and retrospective chart reviews, applying UR criteria to ensure hospital stays are appropriate and fully covered by...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

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...

Sentara Health Plans seeks an RN Clinician to perform utilization management and claim reviews across inpatient and outpatient settings. The role supports pre/post payment reviews and authorization assessments, ensuring compliance with policy and...

St. Tammany Health System in Covington, LA is seeking a Clinical Documentation Specialist - RN to work remotely. The CDS supports accurate representation of illness severity and risk adjustment through collaboration with physicians and care teams.

Medical Review Nurse (RN)Remote position, however candidates must reside in the State of TX or State of ILThis position is a contract for about 9 months.Pay: $41/hourRN working in the insurance or managed care industry using medically accepted...

CHOICES Case Management, Inc. is seeking an Administrative Assistant to support our Nurse Case Managers in a fast-paced healthcare environment. This role serves as the operational backbone, ensuring details are handled, communication flows...

Montefiore St. Luke's Cornwall is seeking a Clinical Documentation Integrity Specialist (CDIS) to improve the quality and completeness of clinical documentation. You will work with physicians and clinicians to ensure documentation reflects the...

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...

Baptist Health is seeking a remote Clinical Documentation Specialist to evaluate physician documentation and ensure accurate illness severity portrayal for coding precision. The role requires an active Kentucky license and involves guiding...

Care Career is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Labor and...

Description: FAMILY NURSE PRACTITIONER JOB SUMMARY Provides continuous and comprehensive services necessary for the promotion of optimal health, prevention and treatment, in an underserved community clinic. To perform a variety of advanced clinical...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

Syneos Health is seeking a Research Nurse (Per Diem) to support clinical trials remotely in IN. The role emphasizes protocol adherence, data integrity, and effective communication with the RN project team and investigators. The ideal...

RN & LPN Virtual Interview Day for Catholic Health Home CareThis is an invite-only event.RN QualificationsNew York State RN licenseMinimum of one year of recent hands on experience as a Registered Nurse.LPN QualificationsLPN License in the state...