• Medical Claim Review Nurse

    Molina Healthcare (Everett, WA)
    …DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate ... more
    Molina Healthcare (04/25/25)
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  • Remote PAC Nurse

    Actalent (Tampa, FL)
    Remote PAC Nurses!Job Description Actalent is looking for PAC Utilization Review Nurses that will work remote ! Qualified candidates must have experience ... more
    Actalent (04/15/25)
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  • Nurse Navigator - Site Disease Group…

    University of Miami (Miami, FL)
    …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Nurse Navigator - Site Disease Group - Remote ... more
    University of Miami (04/16/25)
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  • School Nurse /RN - for Summer Work Program…

    Monroe One Boces (Fairport, NY)
    …2. Work with a team to include- Athletic Directors, Coaches, and the Boces Nurse Practitioner to review student requalification status. 3. Consult with staff ... more
    Monroe One Boces (04/16/25)
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  • Clinical Appeals Nurse ( Remote )

    CareFirst (Baltimore, MD)
    …mental health, psychiatric setting. **Preferred Qualifications:** + 2 years' experience in Medical Review , Utilization Management or Case Management at CareFirst ... more
    CareFirst (04/23/25)
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  • Registered Nurse - Heart Transplant…

    Cedars-Sinai (Los Angeles, CA)
    …a condition of continued employment. **Req ID** : 8897 **Working Title** : Registered Nurse - Heart Transplant Coordinator - Remote ON CALL **Department** : ... more
    Cedars-Sinai (04/17/25)
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  • Delegation Oversight Nurse Remote

    Molina Healthcare (Albany, NY)
    …contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM ... more
    Molina Healthcare (04/20/25)
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  • Nurse Navigator 1 - Site Disease Group…

    University of Miami (Miami, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Location: ... more
    University of Miami (03/08/25)
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  • Remote Registered Nurse

    315 health (Warner Robins, GA)
    …confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and ... more
    315 health (03/12/25)
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  • Care Manager, Registered Nurse

    CVS Health (Montgomery, AL)
    …DSNP into new markets across the country. **Fundamental Components** + Nurse Care Manager is responsible for assessing, planning, implementing, and coordinating ... more
    CVS Health (04/25/25)
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  • Conduit - Registered Nurse (RN) - Transfer…

    Bon Secours Mercy Health (Cincinnati, OH)
    …Health Partners Mission and Values. Works closely through collaboration with clinical, medical staff and leadership teams to identify, trend, and report barriers to ... more
    Bon Secours Mercy Health (04/08/25)
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  • Concurrent Review Nurse

    Actalent (San Antonio, TX)
    Job Title: Review Nurse Job Description The Review Nurse will be responsible for reviewing approximately 20 cases a day to assess medical necessity ... more
    Actalent (04/21/25)
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  • Clinical Review Nurse , Disability…

    Equitable (Charlotte, NC)
    Clinical Review Nurse , Disability Claims ( 25000067 ) **Primary Location** : UNITED STATES-NC-Charlotte **Other Locations** : UNITED STATES- Remote , UNITED ... more
    Equitable (04/04/25)
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  • Conduit - Licensed Practice Nurse (LPN)…

    Bon Secours Mercy Health (Cincinnati, OH)
    …if applicable. + Participates in process improvement, professionaldevelopment and peer review + Responsible for other tasks and analysis as requested /directed. ... more
    Bon Secours Mercy Health (04/08/25)
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  • Case Manager Registered Nurse , IN…

    McLaren Health Care (Indianapolis, IN)
    …This includes but is not limited to the following: participates in the medical management of members in assigned product lines, including case specific and disease ... more
    McLaren Health Care (04/22/25)
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  • Clinical Review Nurse - Concurrent…

    Centene Corporation (Salem, OR)
    …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... more
    Centene Corporation (04/24/25)
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  • Clinical Review Nurse - Prior…

    Centene Corporation (Getzville, NY)
    …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... more
    Centene Corporation (04/20/25)
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  • Transplant Care Nurse RN - Stem Cell, Bone…

    Highmark Health (Carson City, NV)
    …to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and ... more
    Highmark Health (04/25/25)
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  • Utilization Review Registered Nurse

    BJC HealthCare (St. Louis, MO)
    … experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity + Must ... more
    BJC HealthCare (04/23/25)
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  • Clinical Review Auditor - REMOTE

    Community Health Systems (Sarasota, FL)
    (Full-Time, Remote ) The Clinical Review Analyst is a professionally licensed nurse /LPN who is responsible for effectively managing the denial/appeal process ... more
    Community Health Systems (04/23/25)
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