PeaceHealth is seeking a RN Clinical Research for a Per Diem/Relief, 0.00 FTE, Day position. The role involves participating, conducting, and managing clinical research studies, acting as a liaison between the clinic and the outside sponsoring firm, and coordinating and managing patient participation and data management for assigned studies. The position requires an Associate Degree in Nursing, a minimum of 3 years of nursing experience, and offers a salary range of $46.46 - $69.68.

RN Clinical Research- Remote

RN Clinical Research

As a Utilization Review RN at Ascension Seton Northwest, you will provide healthcare services related to admissions, case management, discharge planning, and utilization review. This role involves reviewing admissions and service requests for medical necessity and compliance with reimbursement policy criteria, providing case management and consultation for complex cases, assisting with coding, medical records, precertification, reimbursement, and claim denials/appeals, and overseeing compliance to utilization management rules and regulations.

Utilization Review RN - Utilization Review

Utilization Review RN

PeaceHealth is seeking a RN Clinical Documentation Specialist for a full-time, variable position. The role involves ensuring that physician documentation of patient's diagnosis and treatment is consistent with the Medicare Diagnostic Related Group, reviewing various aspects of the chart to determine if documentation reflects the complexity of the patient and their resource consumption for the hospital stay. This remote position requires the incumbent to reside in OR, WA, AK, or TX.

RN Clinical Documentation Specialist - Remote

RN Clinical Documentation Specialist

Molina Healthcare Services (HCS) works with members, providers, and multidisciplinary team members to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. The role involves ensuring optimum outcomes, cost-effectiveness, and compliance with all state and federal regulations and guidelines through prior authorization reviews.

Care Review Clinician, Prior Auth (RN): South Carolina, REMOTE

Care Review Clinician, Prior Auth (RN)

The Clinical Referral Specialist RN at Sutter Health acts as the in-office clinical liaison, representing the agency via telephone to receive and process referrals for patient care within the regional home health referral management team. This role involves working closely with various referral sources, including hospitals, physicians, and care facilities, to ensure timely and consistent admissions. The position includes entering referral information into the Electronic Medical Records (EMR), creating initial orders for patient care, and requires frequent interaction with referral sources, agency staff, and healthcare professionals across offices.

Clinical Referral Specialist RN  (Arizona, Idaho & Utah Applicants Only)

Clinical Referral Specialist RN

IntellaTriage is seeking part-time Hospice Triage RNs to join their team, offering a remote work setting with a focus on end-of-life care. The role involves working from home, providing triage care without the need for daily commuting. Nurses will work a minimum of one evening shift per week, every other weekend, and may pick up additional shifts as needed. Training is provided remotely, and nurses will utilize technology to manage after-hours care for hospice and home health providers.

Remote Hospice Triage RN- PT 1 shift 3:30p-12a + rotating Sat & Sun 7:30-4p CST

Hospice Triage RN

Providence Health Plan is seeking a Clinical Program Coordinator RN to provide care coordination, case management, and care management services to members. This role involves disease management programs, triage and referral, transition of care planning, end of life care planning, and nurse education. The position offers the flexibility of 100% remote work for applicants residing in specific areas, and emphasizes the importance of patient-focused, whole-person care.

Clinical Program Coordinator RN *Remote*

Clinical Program Coordinator RN

As a Utilization Review RN at Ascension Care Management Insurance, you will provide healthcare services regarding admissions, case management, discharge planning, and utilization review. This role involves reviewing admissions and service requests for medical necessity and compliance with reimbursement policy criteria, providing case management and consultation for complex cases, assisting with coding, medical records, precertification, reimbursement, and claim denials/appeals, and overseeing compliance to utilization management rules and regulations.

The Research Scientist RN at Providence is responsible for leading caregivers in integrating and translating research findings into practice, leading nursing and interprofessional research studies, teaching innovative educational programs, and planning and evaluating the resources necessary to support research studies. This role emphasizes a culture of inquiry, quality improvement, evidence-based practices, and nursing and patient care research. The position is remote and focuses on pursuing a program of research aligned with the strategic vision.

Research Scientist RN - *REMOTE*

Research Scientist RN

The Clinical Effectiveness Consultant, RN at Sutter Health is a remote position focused on reviewing and approving plan of care/physician orders, ensuring excellent attention to detail and computer skills. This role supports quality, clinical, and operational leadership in monitoring and evaluating electronic medical record (EHR) workflow for outcomes management, performance improvement, patient safety, and regulatory compliance. The position requires a California RN license within 90 days of hire and is eligible for applicants residing in Arizona, Idaho, or Utah.

Clinical Effectiveness Consultant, RN

Molina Healthcare Services (HCS) is seeking an RN Clinician, Inpatient Review Case Manager for a night shift role. This position involves assessing, facilitating, planning, and coordinating integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. The role requires working 12-hour night shifts, rotating weekends and holidays, and is remote with a requirement for a valid California RN license and high-speed internet connectivity.

RN  Inpatient Review Case Manager California: NIGHT SHIFT

RN Clinician, Inpatient Review Case Manager

Molina Healthcare Services (HCS) works with members, providers, and multidisciplinary team members to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. This role supports the Senior Whole Health business, focusing on Managed Long-Term Care (MLTC) plans, and requires a RN Care Review Clinician with Prior Authorization experience. Candidates with Utilization Management (UM) and MLTC/LTC experience are highly preferred. The position is remote with light travel for in-person meetings, and offers a competitive benefits and compensation package.

UM Care Review Clinician PA MLTC RN Remote in New York

UM Care Review Clinician RN

The Clinical Operations Supervisor - RN at Acentra Health is responsible for managing the day-to-day operations of Clinical Operations, Utilization Management, and Clinical Reviewers. This role involves assuring quality customer service and support for clients and staff, developing and enforcing operational policies and procedures, managing staff, and coordinating correspondence between external stakeholders and the company. The position requires a proactive approach to problem-solving, team management, and ensuring operational success through business and financial metrics monitoring.

Clinical Operations Supervisor

Clinical Operations Supervisor - RN

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Remote RN Clinical Eligibility Jobs Hiring Now

RN Clinical Research- Remote

Utilization Review RN - Utilization Review

RN Clinical Documentation Specialist - Remote

Care Review Clinician, Prior Auth (RN): South Carolina, REMOTE

Clinical Referral Specialist RN (Arizona, Idaho & Utah Applicants Only)

Remote Hospice Triage RN- PT 1 shift 3:30p-12a + rotating Sat & Sun 7:30-4p CST

Clinical Program Coordinator RN Remote

Utilization Review RN

Research Scientist RN - REMOTE

Clinical Effectiveness Consultant, RN

RN Inpatient Review Case Manager California: NIGHT SHIFT

UM Care Review Clinician PA MLTC RN Remote in New York

Clinical Operations Supervisor