• Clinical Reviewer III (ECSS),…

    Magellan Health Services (Baton Rouge, LA)
    …Worker - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt ... conducting utilization management according to medical necessity criteria. General Job Information Title Clinical Reviewer III (ECSS), Remote in LA Grade 26… more
    Magellan Health Services (06/25/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Review Nurse (Prior…

    Actalent (Miami, FL)
    Immediate hiring for " Remote Clinical Review RN " Job Description: + Review approximately 20 cases a day for medical necessity. + Advocate for and ... : + 3+ Years of experience working with utilization management, concurrent review , prior authorization, utilization review , case management, and discharge… more
    Actalent (07/12/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Clinical Consultant…

    CVS Health (Phoenix, AZ)
    …+ Licensed Professional Counselor (LPC) + Licensed Marriage and Family Therapist (LMFT) + Registered Nurse ( RN ) + Associate-level licenses may be considered ... healthcare for Arizona's most vulnerable populations. In this full-time, remote role, you'll apply your clinical expertise...Care is the place for you. **Key Responsibilities** + Review clinical information and apply medical necessity… more
    CVS Health (07/13/25)
    - Save Job - Related Jobs - Block Source
  • Supervisor, Clinical Documentation…

    Trinity Health (Livonia, MI)
    …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... **Employment Type:** Full time **Shift:** **Description:** ** Remote based work location** **POSITION PURPOSE** At the...regulatory standards are met. Ensures that direct reports perform clinical validation as part of the review more
    Trinity Health (06/09/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Clinical Consultant

    CVS Health (Charleston, WV)
    …function. Required Qualifications: + Licensed independent Behavioral Health clinician or a Registered Nurse ( RN ) with unrestricted state license with ... all with heart, each and every day. **Utilization Management Clinical Consultant** ** Remote - West Virginia** Schedule...Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Registered Nurse ( RN ) with unrestricted… more
    CVS Health (07/12/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Integrity Specialist…

    AdventHealth (Altamonte Springs, FL)
    …LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED: . Current active State license as a Registered Nurse , Nurse Practitioner, Physician's Assistant or an . ... for inpatients, sending/presenting opportunities for improved documentation compliance to physicians, nurse practitioners and other clinical team members. .… more
    AdventHealth (06/11/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Reviewer Utilization…

    US Tech Solutions (Canton, MA)
    …is Fully remote , but Massachusetts RN license required.** **Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse ... clinically complex caseload of varied requests for services. The Clinical Reviewer is responsible for making the...the job** + Bachelor's degree in Nursing, preferred + Registered Nurse with current a and unrestricted… more
    US Tech Solutions (06/23/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse Hybrid - Hospital…

    Roper St. Francis (Charleston, SC)
    …Purpose of Position** Virtual Registered Nurse /Hybrid will alternate work shifts as Clinical RN and the Remote Patient Monitoring RN . This ... the designated care setting and remotely as a Virtual Registered Nurse as designated by their department....Nurse as designated by their department. In their Clinical RN role, they will provide nursing… more
    Roper St. Francis (06/19/25)
    - Save Job - Related Jobs - Block Source
  • RN - Registered Nurse

    Geisinger (Danville, PA)
    …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... work on site position located in Danville, Pennsylvania. The Clinical Documentation Improvement Program (CDI) is designed to improve...highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to… more
    Geisinger (05/22/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN

    Banner Health (Sun City, AZ)
    …through the completion of a Bachelor's Degree in Nursing. Requires a current Registered Nurse ( RN ) license. Experience typically gained through two ... abilities - apply today. **Banner MD Anderson Cancer Center Clinical Trials** Office is the oncology service line for...on site to support our patient facing requirements, however remote and schedule flexibility options are also offered following… more
    Banner Health (07/10/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Specialist, First…

    SSM Health (MO)
    …Division of Professional Registration + Or + Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by Compact State + Or + Registered ... **It's more than a career, it's a calling** MO- REMOTE **Worker Type:** Regular **Job Highlights:** **Must have...+ Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by… more
    SSM Health (07/12/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Management Nurse Consultant…

    CVS Health (Carson City, NV)
    …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team....managed care organization (MCO). + Experience in a high-volume clinical call center or prior remote work… more
    CVS Health (07/01/25)
    - Save Job - Related Jobs - Block Source
  • Second Level Reviewer I PRN Remote

    AdventHealth (Altamonte Springs, FL)
    …CERTIFICATION OR REGISTRATION REQUIRED** **:** . Current active State license as a Registered Nurse , Nurse Practitioner, Physician's Assistant or an ... for inpatients, sending/presenting opportunities for improved documentation compliance to physicians, nurse practitioners and other clinical team members. .… more
    AdventHealth (06/12/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN Inpatient…

    HCA Healthcare (Mcallen, TX)
    …path, we encourage you to apply for our Registered Nurse RN Inpatient Rehab opening. We review all applications. Qualified candidates will be contacted ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse RN Inpatient Rehab...BSN is preferred. . Minimum of 1 year of clinical experience as a Registered Nurse more
    HCA Healthcare (06/21/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN

    HCA Healthcare (Mcallen, TX)
    …Regional Hospital we support our colleagues in their positions. Join our Team as a(an) Registered Nurse RN Pediatrics and access programs to assist with ... gain certifications and job skills. Apply today for our Registered Nurse RN Pediatrics opening...of Pediatric clinical experience as a licensed Registered Nurse ** **.Current Registered more
    HCA Healthcare (06/21/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Appeals Nurse

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …regulatory timeframes.The TeamAs an integral part of the Appeal Review team, the Clinical Appeals Nurse Reviewer will serve as a liaison and business ... healthcare? Bring your true colors to blue. The RoleThe Clinical Appeals Nurse Reviewer is...our eWorker persona ( remote ). Key Responsibilities: + Review provider and member appeals utilizing sound clinical more
    Blue Cross Blue Shield of Massachusetts (06/26/25)
    - Save Job - Related Jobs - Block Source
  • RN Utilization Management Reviewer

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …help us transform healthcare? Bring your true colors to blue. The Role The RN Utilization Management Reviewer is responsible for facilitating care for members ... and works independently and collaboratively to facilitate care using clinical skills, principles of managed care, nationally recognized medical...to provide the best quality care. The Team The RN Utilization Management Reviewer is part of… more
    Blue Cross Blue Shield of Massachusetts (07/11/25)
    - Save Job - Related Jobs - Block Source
  • Tele-Triage Registered Nurse

    BrightSpring Health Services (Louisville, KY)
    …Qualifications + Degree/certification from an accredited school of nursing + Current licensure as a Registered Nurse ( RN ) in the state of practice, which is ... Our Company Starting Point Nursing Services Overview RN Tele-Triage (Fully Remote ) *Must have...*Thursday, Friday & Saturday 11p-6a CST (12a-7a EST) This Registered Nurse provides On-Call and Triage for… more
    BrightSpring Health Services (07/09/25)
    - Save Job - Related Jobs - Block Source
  • School Registered Nurse ( RN

    The Arc Erie County NY (Buffalo, NY)
    …life by creating opportunities through comprehensive services for over 65 years. Are you a Registered Nurse ( RN ) looking for a flexible schedule plus: + ... Arc Erie County is currently seeking a Full Time Registered Nurses ( RN ) for our school age...full Job Description listed below Job Description Job Title: Registered Nurse Department: Clinical Services… more
    The Arc Erie County NY (04/30/25)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse RN Medical…

    Banner Health (Gilbert, AZ)
    …include working in an acute care setting within the past 12 months as a Registered Nurse in the specialty area. Banner Registry and Travel physician practice ... being added at a later date. As an **Med/Surg RN ** , you will work closely with MD Anderson...require a minimum of one year experience as a Registered Nurse in a physician practice or… more
    Banner Health (06/07/25)
    - Save Job - Related Jobs - Block Source