• Utilization Management Clinical Team Lead…

    CVS Health (Little Rock, AR)
    …high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position Summary** The Team Lead ... including extended periods of sitting, computer use, and document review . + Participate in occasional on-call rotations, including some...managed care organization (MCO). + Experience in a high-volume clinical call center or prior remote work… more
    CVS Health (08/16/25)
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  • Clinical Documentation Integrity Specialist…

    Marshfield Clinic (Marshfield, WI)
    …are substantially related to the position._ **Minimum Required:** Current state Registered Nurse license **OR** Active credentials through AHIMA (RHIA). ... to support the most exciting missions in the world!** **Job Title:** Clinical Documentation Integrity Specialist ( Remote ) **Cost Center:** 101651052 HIM-… more
    Marshfield Clinic (09/09/25)
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  • Vice President, Population Health…

    Centene Corporation (Carson City, NV)
    …+ Oversees performance of all UM functions (prior authorization, concurrent review ) for the market per the defined partnership agreement*Orchestrates all elements ... with MDs to translate the needs of the members into intentional clinical program design that delivers successful health outcomes*Liaises with state regulators for… more
    Centene Corporation (08/17/25)
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  • Program Lead II, Clinical Program…

    AbbVie (San Francisco, CA)
    …YouTube, LinkedIn and Tik Tok (https://www.tiktok.com/@abbvie) . Job Description The Clinical Operations Program Director is responsible to connect science and ... operations to bring clinical studies to life through the execution of one...strategic partner for the Asset Strategy Team and Development Review Committee whose remit is to maximize the value… more
    AbbVie (08/13/25)
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  • 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 ... Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position At the direction of the Regional Manager,...regulatory standards are met. Ensures that direct reports perform clinical validation as part of the review more
    Trinity Health (08/26/25)
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  • Surgical/ Clinical Screen NSQIP…

    BJC HealthCare (St. Louis, MO)
    …relevant work experience) **Additional Information About the Role** BJC is hiring for a Surgical/ Clinical Reviewer . This is a remote position. Must be ... medical schools in the country. **Preferred Qualifications** **Role Purpose** The Surgical Clinical Reviewer (SCR) is responsible for abstracting and sharing… more
    BJC HealthCare (07/26/25)
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  • Clinical Manager, Behavioral Health (UM)…

    Magellan Health Services (Boise, ID)
    …Professional Counselor - Care MgmtCare Mgmt, PC - Professional Counselor - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - ... for RN , Masters or Doctoral level provider. General Job Information Title Clinical Manager, Behavioral Health (UM) -Licensed, Remote in Idaho Grade 27 Work… more
    Magellan Health Services (08/26/25)
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  • Registered Nurse ( RN

    Roper St. Francis (Mount Pleasant, 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 (07/25/25)
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  • Registered Nurse - 100%…

    TEKsystems (Dallas, TX)
    Job Title: Clinical Quality Assurance Coordinator Location: Remote , equipment provided Pay Rate: RN - $29/hour Shift: 11:30AM - 8PM EST Training: 9am-5:30PM ... EST, 4-6 weeks Overview: We are seeking Clinical Quality Assurance Coordinators to support the ...clinical knowledge to support accurate reviews + Previous remote work experience is a plus Pay and Benefits… more
    TEKsystems (09/06/25)
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  • Registered Nurse ( RN

    LA Care Health Plan (Los Angeles, CA)
    Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & Grievances ... presentations. Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
    LA Care Health Plan (09/09/25)
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