• Remote Utilization Review Nurse

    Actalent (Orlando, FL)
    Job Title: Clinical Review Nurse Job Description As a Clinical Review Nurse , you will perform concurrent reviews to assess members' overall health, review the ... Texas nursing license. Work Environment This is a fully remote position with working hours from 10 am to...or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to… more
    Actalent (08/02/25)
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  • UM LVN Delegation Oversight Nurse

    Molina Healthcare (Oakland, CA)
    …Preservice and outpatient experience. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM ... as well as Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will assist the Delegation Oversight Manager with additional duties of the… more
    Molina Healthcare (07/09/25)
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  • Disease Management Nurse - Remote

    Sharecare (Columbia, SC)
    …To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and objectives of the ... and cost-effective manner while ensuring high quality care. The Disease Management Nurse works with participating members to become empowered and active participants… more
    Sharecare (07/12/25)
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  • Prior Authorization Registered Nurse

    CVS Health (Oklahoma City, OK)
    …do it all with heart, each and every day. **Position Summary** This is a **fully remote role** with a requirement to **reside in Oklahoma** . The nurse in this ... position uses clinical expertise in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate healthcare services and benefits for members. Responsibilities include gathering clinical information, applying evidence-based guidelines… more
    CVS Health (07/26/25)
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  • Utilization Review Nurse ( Remote )

    Actalent (San Antonio, TX)
    Urgent Hiring for " Remote Clinical Review Nurses" Job Description: + Review approximately 20 cases a day for medical necessity. + Advocate for and protect members ... Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Aug 6,… more
    Actalent (08/04/25)
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  • Care Manager, Registered Nurse

    Sharecare (San Juan, PR)
    …a matrix organizational design. **Qualifications:** + Current multi-state compact Registered Nurse licensure in state of residence is required, with ability to ... obtain additional licenses without restriction. BSN preferred. + Training in motivational interviewing preferred. + Minimum 3-5 years varied clinical experience with telephonic Case Management experience strongly preferred. + Demonstrates computer competencies… more
    Sharecare (07/08/25)
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  • Case Manager Registered Nurse

    CVS Health (Austin, TX)
    …**Working hours :** **Monday through Friday 9** **:00am to 6:00pm CST. There are c** **urrently no nights, no weekends, and no holidays; however, it is subject to ... change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member and to help facilitate the… more
    CVS Health (08/01/25)
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  • Utilization Management Nurse Consultant…

    CVS Health (Hartford, CT)
    …high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key Responsibilities** + ... EST Hours; Shift times may vary based on business needs) **Location** : 100% Remote (US only) **Position Summary** American Health Holding, Inc. (AHH), a division of… more
    CVS Health (08/01/25)
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  • Quality Management Nurse Consultant…

    CVS Health (Phoenix, AZ)
    …plan administered by Aetna, a CVS Health company, is seeking a Quality Management Nurse Consultant to help ensure the highest standards of care for our diverse ... member population. In this remote role, you'll be part of a collaborative, experienced,...+ Requires some travel to provider locations as needed. ** Remote Work Expectations** + This is a remote more
    CVS Health (07/13/25)
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  • Registered Nurse (RN) Hybrid - Hospital…

    Roper St. Francis (Summerville, SC)
    …(weekly) remote ** **Primary Function/General Purpose of Position** Virtual Registered Nurse /Hybrid will alternate work shifts as Clinical RN and the Remote ... with the South Carolina Nursing Practice Act. In the Remote Patient Monitoring Nurse role, they will provide professional nursing care through skillful… more
    Roper St. Francis (07/25/25)
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