- Centene Corporation (Oklahoma City, OK)
- …rotating holidays.** **Location Requirement: Must reside in Oklahoma.** + **Conduct clinical reviews for medical necessity (utilization review ).** + ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Evolent (Lansing, MI)
- …the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as...I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools… more
- Actalent (Baton Rouge, LA)
- Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a critical role in analyzing prior authorization requests to ... cost-effectiveness of medical care. Responsibilities + Perform medical necessity and clinical reviews of authorization requests to determine the appropriateness of… more
- UCLA Health (Los Angeles, CA)
- …related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established ... Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role...and efficient utilization of resources. Key Responsibilities: + Conducts clinical reviews of prior authorization requests to… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 11/19/2025 **Requisition Number** PRN43626B **Job Title** PS Clinical Nurse Specialist **Working Title** PS Clinical Research Nurse ... responsibilities and qualifications required of employees assigned to the job. The Clinical Nurse Specialist makes decisions independently and in collaboration… more
- State of Colorado (Pueblo, CO)
- NURSE III - Clinical Specialist - Pueblo Regional Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5186234) Apply NURSE III - ... minimum staffing standards. This includes covering as a team nurse as needed. This position exists as a unit...and Health Care Technicians/QMAP. + Through direct observations and review of documentation determines if nurses are practicing critical… more
- YAI (Brooklyn, NY)
- …disabilities and their families. Key/Essential Functions & Responsibilities: + Report to the nurse manager or nurse supervisor, at Premier HealthCare (PHC). Meet ... on a weekly basis for supervision to review duties and responsibilities. + Accountable for the day-to-day...and followed as directed. + Assume duties of the nurse supervisor when needed and provide coverage for and… more
- Actalent (Miami, FL)
- Urgent Hiring for "Remote Clinical Review Nurses" Job Description: + Review approximately 20 cases a day for medical necessity. + Advocate for and protect ... and complete cases. Qualifications: + 3+ years of utilization management, concurrent review , prior authorization, utilization review , case management, and… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 12/17/2025 **Requisition Number** PRN16627N **Job Title** PS Clinical Nurse PRN **Working Title** PS Clinical Nurse PRN **Career ... Rate Range** 44.10 per hour **Close Date** 03/17/2026 **Priority Review Date (Note - Posting may close at any...College of Nursing is seeking a compassionate and skilled Clinical Registered Nurse to join our team… more
- HCA Healthcare (Asheville, NC)
- …Hospital we support our colleagues in their positions. Join our Team as a Clinical Nurse Coordinator Trauma Spine and access programs to assist with every ... Mission Health! Only new hires eligible for sign-on bonus; prior employees have to be separated from Mission for...gain certifications and job skills. Apply today for our Clinical Nurse Coordinator Trauma Spine opening and… more