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Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

Clinical Appeals and Grievances Specialist Will this role be fully remote? Yes. Are there any specific locations the candidates should be in (i.e., do they need to live in IL)? No but must have CA license. Work Schedule/Shift & Time Zone:...

Cambia Health Solutions is hiring a Clinical Specialist to work from home across Idaho, Oregon, Utah, and Washington. The role supports utilization management by handling nonclinical tasks, coordinating with providers, and documenting cases while...

Improve the lives of others while Caring. Connecting. Growing together.Job Description - HSS Clinical Coordinator RN - Telecommute in Texas (2391171)HSS Clinical Coordinator RN - Telecommute in Texas - 2391171At UnitedHealthcare, we are...

Virtual Care Registered Nurse We are seeking a licensed Registered Nurse to deliver virtual care to patients on behalf of one of our partner organizations. This role involves delivering remote patient care, symptom triage, health...

The Registered Nurse is responsible for overseeing the health, wellness, and psychiatric stability of patients receiving Full-Service Partnership (FSP) and broader outpatient behavioral health services. The position is primarily...

Responsible for the retrospective review of medical records and compiling data to validate quality of...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

Health Advocates Network is currently seeking a Registered Nurse to work at a facility in Los Angeles, California. These are registry positions with our company. Job Details: • Pay: Range...

Hospice RN Case Manager Hospice of Western & Central Massachusetts is seeking a compassionate and experienced Hospice RN Case Manager to join our team! As a key member of our care team, you will provide exceptional hospice care to...

Job Opportunity Our client is a private health management company devoted to providing an exceptional clinical team in the comfort, and privacy of a patient's own home. We are seeking dynamic, experienced, and compassionate Registered...

Nurse Case Manager Responsibilities The Nurse Case Manager shall provide a full range of professional health nursing principles, practices, and procedures in clinical settings in order to analyze the full scope of problems...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end...

Summary This is an OPEN CONTINUOUS ANNOUNCEMENT & will remain open until 10/29/2026 or until filled. Qualified applicants will be referred to hiring managers at regular intervals. Your application will remain active for 3 months.

Mass General Brigham Health Plan Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we...

Grace Community Care & Homes seeks a part-time Psychiatric Mental Health Nurse Practitioner (PMHNP) for planned New Jersey mental-health and substance-use services. The role includes psychiatric evaluations, prescribing, medication follow-ups and...

Description Research Nurse (Per Diem) - Oahu, Hawaii Illingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device industries. These include...

Utilization Management Nurse I, RN Huntington Beach Office - Huntington Beach, CA 92647; Arcadia Office - Arcadia, CA 91007 Overview Salary Range $72,758.00 - $89,128.00 Salary/year Position Type Full Time...

Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our...

Job TitleCHA Hollywood Presbyterian Medical Center is committed to serving local multicultural communities with quality medical and nursing care. With more than 500 physicians representing virtually every specialty, HPMC strives to distinguish...

Managed Medical Review Organization, Inc. is seeking an experienced RN to join our team in a remote, home-office capacity. The role emphasizes telephonic/customer service, accurate documentation, and clinical review of cases. Candidates...

Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

Color is revolutionizing cancer care with the nation's first Virtual Cancer Clinic, delivering high-quality, physician-led multidisciplinary care across all 50 states. Our innovative, guideline-based approach spans cancer screening, risk...

Family/Adult Nurse Practitioner – Telehealth A leading healthcare organization is seeking an experienced Family or Adult Nurse Practitioner to provide virtual primary and urgent care to adult patients receiving home and community-based...

TravSource is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Torrance, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN...