• Clinical Reviewer , Nurse

    Evolent (Providence, RI)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
    Evolent (12/10/25)
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  • Research Nurse Practitioner

    Brown University (Providence, RI)
    …and conduct support activities related to these duties. The Research NP will review medical histories with research participants, perform a physical examination ... Job Description: Position Purpose: The Research Nurse Practitioner (NP) will provide medical ...research participation, and administer questionnaires. The Research NP will review health updates and adverse event reports from study… more
    Brown University (10/31/25)
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  • Nurse Auditor 2

    Humana (Providence, RI)
    …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
    Humana (12/11/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Providence, RI)
    …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
    CVS Health (12/16/25)
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  • Nurse - Individualized Care, Access…

    Cardinal Health (Providence, RI)
    …both scheduled outbound calls and inbound call queue. + Meets regularly with Clinical Supervisor and/or Senior Nurse , Individualized Care to discuss feedback ... who need them-faster.** **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties… more
    Cardinal Health (12/09/25)
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  • CDQI Nurse Specialist - Part Time - Remote

    Datavant (Providence, RI)
    …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
    Datavant (11/11/25)
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  • Registry Abstraction Nurse

    Highmark Health (Providence, RI)
    …:** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support ... Preferred + Associate's or Bachelor's Degree in Nursing + 1 year performing medical record review and data abstraction for cardiovascular registries + Proficient… more
    Highmark Health (12/05/25)
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  • Case Manager Registered Nurse

    Prime Healthcare (Woonsocket, RI)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/236668/case-manager-registered- nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityLandmark … more
    Prime Healthcare (12/04/25)
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  • Case Manager Registered Nurse

    Prime Healthcare (Woonsocket, RI)
    …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/235322/case-manager-registered- nurse /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityLandmark … more
    Prime Healthcare (11/20/25)
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  • Triage Nurse - Primary Care

    University Medicine (East Providence, RI)
    …and chief complaint. + Obtains lab specimens, gives injections, and performs routine medical tests. + Implements clinical and technical aspects of nursing care ... as they pertain to office nursing, which includes routine medical exams and/or procedures and tests in conjunction with...with prescribed policies, procedures, and techniques. + Assisting with review of test results under guidance of a physician… more
    University Medicine (10/23/25)
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