Jaybird Senior Living

Virtual Triage Nurse (RN or LPN

Posted on:

May 28, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Not Specified

Jaybird Senior Living operates senior living communities providing care and support for older adults. Founded in 2004, the company focuses on resident-centered services and employs clinical and caregiving staff across its communities.

Virtual Triage Nurse ( RN or LPN) The Virtual Triage Nurse (RN or LPN) independently provides remote clinical triage and guidance to community caregivers and floor nurses under the supervision of the Director of Clinical Operations. This role requires sound clinical judgment, adherence to state regulations, and a commitment to Jaybird Senior Living's core values. Key Responsibilities • Act as the primary on-call triage resource for property staff, providing clinical advice and directing appropriate action based on resident care plans and regulations. • Identify and manage emergent situations, instructing staff to contact emergency services when necessary. • Analyze resident conditions (symptoms/incidents) to determine and communicate next steps and expected outcomes to callers. • Maintain clear, complete, and confidential documentation of all conversations and directives, ensuring HIPAA compliance. • Utilize clinical and administrative platforms to review resident data and documentation. • Identify call trends and collaborate with corporate leadership to develop proactive solutions and improve resident outcomes/length of stay. • Consult and collaborate with internal/external clinical staff on quality improvement projects and research. • Troubleshoot basic access concerns for clinical platforms. Required Qualifications & Skills • License: Active RN or LPN license in good standing (LPN must be overseen by an RN). • Expert Knowledge: State-specific training, program, and regulatory requirements. • Skills: Outstanding verbal/written communication, organizational skills (tracking calls/outcomes), and the ability to relate professionally to staff at all levels. • Tech: Proficiency with Microsoft Windows (Outlook, Word, Excel), Internet, Clinical Platforms, and Apple iPad. • Physical/Cognitive: Ability to sit, talk, hear, and use hands regularly. Ability to read/analyze professional journals and solve practical problems. • Reports To: Director of Clinical Operations • FLSA: Non-Exempt The Perks That Matter: • Competitive salary and bonus opportunities • Health, dental, vision, disability, and life insurance • 401(k) with match • Paid time off and flexible hours • Employee assistance program and on-demand pay • Career growth in a fast-growing company About Jaybird Senior Living We provide seniors with the exceptional care they deserve, in an extraordinary living environment. Our communities offer seniors the freedom to enjoy each day as they see fit, with the right level of care and support; helping them approach life with renewed confidence and purpose. Since 2004, we’ve created a culture where our staff can innovate and grow — while our residents thrive and their families enjoy peace of mind. The Minnesota Equal Pay for Equal Work Act requires employers in the state of Minnesota to disclose the following information. If the position applied to is not located in Minnesota, the following information may not apply. The base range represents the low and high end of the pay range for this position. Actual pay will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. The range listed is just one component of our total compensation package for employees. Other rewards may include annual bonuses, short- and long-term incentives, and program-specific awards. In addition, we provide a variety of benefits to employees, including medical, dental, and vision insurance coverage, disability insurance, 401(k) with match, paid time off (PTO), Flexible hours for better work-life balance, Employee assistance program, on-demand pay. We are committed to providing equal employment opportunities to all employees and applicants. We prohibit discrimination and harassment of any kind, regardless of race, color, religion, age, sex, national origin, disability status, genetics, veteran status, sexual orientation, gender identity, or any other protected characteristic under federal, state, or local laws.

IntellaTriage

Nurse Triage RN PT 5p-11p wkday & 8a-4p/2p-10p Sat & Sun

Posted on:

May 28, 2026

Job Type:

Active

Role Type:

Triage

License:

Compact RN

State License:

Compact / Multi-State

IntellaTriage is a healthcare organization that provides remote nurse triage and advice-line services, supporting patients and client healthcare teams with telephonic nursing care and clinical support.

IntellaTriage continues to GROW! IntellaTriage Nurses enjoy the benefits of working from home, providing care, without the stress and expense of commuting each day! • MUST have or be willing to obtain a Compact RN license • MUST live in/work from a Compact US state • Minimum of 2 years as a Nurse • Minimum of 1 year of experience in a fast-paced environment (i.e. ED, Critical Care, Surgical Services, Med/Surg, etc.) • Must have high speed internet • Must be tech savvy, enjoy a fast-paced environment, and have no concerns typing • Must be available to work 2 out of every 3 weekends & 1 weekday per week > 3 shifts per 2 week pay period Mon-Fri, rotating 5p-11p CST > 2 of every 3 weekend rotation (Sat & Sun) rotating 8a-4p/ 2p-10p Our Nurse Advice Line Nurses: • Have proven experience in a fast-paced, critical-thinking environment; ED, Critical Care, Surgical Services, etc • Work a minimum of 2-3 shift per week (Mon-Fri) • Preferred scheduling for their weekday requirements • Work 2 weekends or every 3 weeks, both Saturday and Sunday on those weekends with rotating times. (For example: weekend 1: work, weekend 2: work, weekend 3: off) • Train for 3 weeks. First week is Monday-Thursday 9a-6p CST. Remaining two weeks training will be dependent upon preceptor availability but will likely be an evening shift. • Must have a compact license and live in that compact state. (no states with pending legislation or future implementation dates are considered current compacts) What is important to know? We are growing and excited to be able to support our clients' nursing staffs in the field who need time to focus on work-life balance, as well, while being able to trust that we are there to support them and their patients during nights and weekends! • Patient care is #1. We do not have call quotas. We employ the best nurses to provide the best care • When our patients or their families reach our triage line, they immediately speak directly with a nurse • We do not have PRN positions • We are super busy. If you like fast-paced roles, keep reading.. • Any nurse may pick up additional shifts, if shifts are available for the clients' they are trained to support • We will provide you with a laptop and headset • Nurses are required to provide their own high-speed internet (only fiberoptic or coaxial cable internet is compatible with our remote call center technology) • Our laptop is required to be directly connected to your modem. Working through Wi-Fi is not compatible with our systems. The calls will drop • It is essential to have a home office or quiet space free from noise or distractions in your home (Privacy/HIPAA compliant space is required) • Training is provided remotely and is paid; no travel is required in this role • MUST be able to follow instructions (verbal and written) and be comfortable with technology (tech savvy) • Must remain in good standing and ensure their home state license remains active • IntellaTriage will cover the cost of non-compact state licensure based on the client(s) that are assigned for support • All nurses must have a compact license and reside/work in that state • Shift prep is a minimum clock-in of 30 minutes prior to taking calls; this is paid time to prepare • Once calls roll to the next team/shift, our nurses remain clocked in and complete any remaining charting before leaving for the day. This may take 30 minutes or this may take 2 hours. It depends on the pace of the calls received during that shift and the pace of your ability to quickly navigate technology and type Sound exciting to you? Then... put those days on the floor and that commute or hours on the road between patients' homes behind you! Our nurses enjoy working from their own home office; no more purchasing scrubs, expensive takeout, and the large gas bill along with extra wear-and-tear on your vehicle. Most importantly, working remotely enables you to spend more time with those you love! Requirements • MUST have or be willing to obtain a Compact Nursing License (States with pending legislation or future implementation dates are not considered current compacts until the implementation date.) • 3+ years as a RN • Experience in a fast-paced environment: i.e. ED, Surgical Services, or Critical Care • Must be comfortable with technology and accessing multiple applications remotely to perform documentation during calls • Ability and comfort typing • Fluency in English is required, additional languages are a bonus • Must physically reside in the U.S. and be legally eligible to work for any employer • Must be able to complete the 3-week orientation and training (Schedule listed in this posting) • Must be available to work Saturday & Sunday on your team's required weekends; 2 of every 3 weekends • Holidays as they are required (rotation) • Able to handle stress and multitask when calls are coming in (minimum of 5+ calls per hour on weekdays, and much higher on weekends) • Able to communicate with patients and families with empathy while also maintaining adherence to client protocols • Must maintain CEU's as designated by the states you are answering calls in • Must attend any in-services, additional training on an as needed basis • Able to pass background check and nurse licensing check Benefits All Remote Nurse Advice Line RN's, once trained to their originally assigned team are at $25/hourly. All part-time nurses accumulate PTO, based on the number of hours they work (per year). All part-time nurses receive an additional 3-paid-sick-days per year. All part-time nurses are eligible to participate in our 401(k) plan.

Spakinect

*Part-Time* Aesthetic Telehealth Nurse Practitioner, CA TX

Posted on:

May 28, 2026

Job Type:

Active

Role Type:

Nurse Practitioner

License:

NP

State License:

California

Spakinect is an aesthetic telehealth company that connects medical spas and clinics with remote providers to perform virtual consultations and Good Faith Evaluations for aesthetic treatments across multiple U.S. states.

This is a remote position. *This role is for a remote PART-TIME position with an anticipated start date as early as June 1st, 2026* Are you an Aesthetic Nurse Practitioner seeking a new and exciting growth opportunity in a remote environment? Spakinect is a successful and growing business in the Aesthetic Telehealth arena with hundreds of clients located in Arizona, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Washington D.C., Wisconsin, and Wyoming. We are looking for a provider with multiple state licensures and candidates must have weekday and weekend availability between the hours of 8am-6pm PST. The part-time role requires a minimum of 12 hours of availability weekly and a weekend requirement of 2-3 Saturdays/month. Any additional weekly availability is a plus! To be considered for this opening, you must have prior aesthetic medicine experience, hold active licenses in California and Texas. Additional licenses in our states of operation are highly desired. Applicants may be considered if CA and TX licenses are submitted and in pending status in addition to having previous aesthetic medicine experience. The starting base rate for this position is $63/hour, however candidates with additional desirable licensure and experience may be eligible to receive a higher starting rate. What you will do at Spakinect: The Aesthetic Telehealth Provider conducts live, interactive Good Faith Evaluations (GFEs) for medical spas and clinics with patients seeking aesthetic treatments throughout the United States from the comfort of their home office. This fast-paced and dynamic position requires excellent communication skills, efficiency, adaptability, independent clinical decision making, and the ability to provide impeccable customer service. The Aesthetic Telehealth Provider maintains a positive, figure-it-out attitude, and is proficient with technology. Spakinect medical providers embrace teamwork and seek collaboration with their colleagues to deliver safe, evidenced-based, high-quality care. Essential Duties and Responsibilities • Deliver thorough, efficient, and exceptional healthcare by reviewing health histories, screening for any contraindications to treatment, and providing treatment plan recommendations for desired aesthetic treatments. • Displays superior customer service by addressing client and patient care concerns, answering clinical questions, and providing medical guidance as necessary. • Demonstrates behavior that is kind, compassionate, polite, friendly, and respectful towards patients, clients, and co-workers. • Effectively communicates with office staff regarding any administrative issues that arise in a timely manner; demonstrates accountability. • Documents electronically using an Electronic Health Record (EHR) system to submit completed GFEs in real-time. • Exhibits the ability to troubleshoot basic technical problems to resolve any potential issues, reaches out appropriately for further assistance when needed. • Adheres to company guidelines and policies, completes all required training, attends continuing education opportunities for growth and development. • Improves productivity and efficiency by developing and implementing standards and processes. • Fosters and embraces best care practices. • Demonstrates Spakinect’s company core values and mission. • Performs other duties as assigned. Requirements Education and/or Experience Master's degree from an accredited college/university or equivalent with related experience in the aesthetic industry. Aesthetic Industry Experience​ In-depth knowledge of aesthetic medicine and treatments offered by industry. Knowledge of legal regulations and best practices in healthcare. Up to date with ever-changing standards in telehealth and aesthetic administration. Licensing Qualified candidates must hold active licenses in California and Texas. Preferred licensure for hire are active medical licenses in good-standing in additional states of operation. Aesthetic Telehealth Provider candidates must be willing and able to acquire additional licensure in requested states of operation. Availability Must have weekday and weekend availability between the hours of 8am-6pm PST. Must be able to provide a minimum of 12 hours of weekly availability and be willing to work 2-3 Saturday shifts per month. Additional weekly availability is a plus! Benefits Benefits are granted upon 90 days of employment, unless specified otherwise. Although benefits are subject to change, part-time employees are currently entitled to: • 1 hour of sick leave for every 30 hours worked • Eligible for participation in company’s 401K plan • Coverage of Malpractice Insurance in all states of operation • Reimbursement for initial licensing fees in requested states of operation upon completion of the 90 day probationary period (excludes previously acquired licenses) • Reimbursement for license renewal fees in states of operation requested by the Company • Membership to NetCE for continuing education classes • Employee incentives via Bonusly. • Company provided laptop

Optum

Senior Clinical Admin Nurse RN - Remote

Posted on:

May 28, 2026

Job Type:

Active

Role Type:

Case management nurse

License:

Compact RN

State License:

Compact / Multi-State

Optum, part of UnitedHealth Group, is a health services and innovation company delivering care, data, pharmacy and population health solutions to improve health outcomes.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Undergraduate degree or equivalent experience • Current, unrestricted Compact RN license • 2+ years of experience in Infusion Therapy and Home Health with specific proficiency in infusion therapy • Knowledge of and experience with Microsoft Office and electronic medical records (EMR) programs • Willing and/or able to obtain additional RN licensures in the states of: AK, CA, HI, IL, MA, MI, MN, NV, NY and OR if licensure is not currently active • Willing and able to work with an interdisciplinary team of professionals including pharmacists and technicians, physicians and other licensed prescribers, registered dietitians, home health agencies (HHAs), sales representatives, and others as needed to provide comprehensive care and support of patients and caregivers • Demonstrated advanced interpersonal communications, both written and verbal • Proven ability to maintain confidentiality in all aspects of patient, staff and agency information • Proven ability to work independently in home or alternate site settings • Proven ability to work under pressure with clinical emergencies if required • Ability to assume a flexible work schedule • Ability to meet attendance, overtime, on-call, and other reliability requirements of the job • Ability to work under pressure with clinical emergencies if required • Able to work Monday - Friday, from 8:00 am - 5:00 pm PST, with occasional Saturday coverage Preferred Qualifications: • CRNI (Certified Registered Nurse Infusion) • 3+ years of experience in Infusion Therapy and Home Health with specific proficiency in infusion therapy • Experience within a healthcare organization providing coordination and navigation of patient care between providers • Knowledgeable and/or experience in HIPAA; OSHA; JCAHO • Knowledge of the Infusion Nursing Society (INS) standards of practice, policies and procedures • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Fuze Health

Remote Telehealth Nurse - Compassionate Patient Care

Posted on:

May 28, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Not Specified

Fuze Health is a healthcare organization that offers telehealth services and hires remote nursing professionals to provide virtual patient care and support.

Fuze Health is looking for a Registered Nurse to provide telehealth care. This role involves conducting remote patient assessments, ensuring compliance with healthcare measures, and educating patients on their conditions. Ideal candidates will have a BSN, 2+ years of nursing experience, and skills in telehealth. The position offers $38.00–$40.00/hour with great benefits like flexible vacation and health insurance.

Monogram Health, Inc.

Registered Nurse Clinical Performance Lead

Posted on:

May 28, 2026

Job Type:

Active

Role Type:

Remote nursing leadership roles

License:

RN

State License:

Not Specified

Monogram Health is a healthcare company focused on care management and value-based services for patients with kidney disease, working with providers and payers to improve clinical outcomes.

Seeking a proactive and motivated Registered Nurse Clinical Performance Lead to work full-time remotely, responsible for managing clinical interventions, supporting patient care and treatment, and ensuring quality assurance and compliance for members affected by renal disease. Key responsibilities • Review and manage clinical interventions, support RNs with action plans, and conduct concurrent hospital reviews • Approve care plans, facilitate case rounds, and address clinical escalations from field clinicians • Audit medical charts, conduct data analysis, and provide guidance on compliance and documentation Required qualifications • Current, active unrestricted license as a Registered Nurse in assigned states/territories • Minimum of 2 years of Registered Nurse experience within the last 5 years or equivalent clinical experience • Demonstrated knowledge and proficiency using technology

Centene Corporation

Clinical Review Nurse - Concurrent Review

Posted on:

May 28, 2026

Job Type:

Active

Role Type:

Utilization Review

License:

RN

State License:

Compact / Multi-State

Centene Corporation is a diversified healthcare company that provides managed care and health plan services to government-sponsored and commercial programs across the United States.

You could be 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, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member. This is a 100% remote position that supports out Health Plan in Oregon, must have or willing to obtain an OR License. Prefer candidate to reside in Central, Mountain or Pacific Time Zones. • Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care • Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay, and discharge planning of member • Works with Medical Affairs and/or Medical Directors as needed to discuss member care being delivered • Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines • Works with healthcare providers to approve medical determinations or provide recommendations based on requested services and concurrent review findings • Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members • Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines • Reviews member’s transfer or discharge plans to ensure a timely discharge between levels of care and facilities • Collaborates with care management on referral of members as appropriate • Performs other duties as assigned. • Complies with all policies and standards. Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience. 2+ years of acute care experience required. Clinical knowledge and ability to determine overall health of member including treatment needs and appropriate level of care preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: • LPN - Licensed Practical Nurse - State Licensure required • RN - Registered Nurse - State Licensure and/or Compact State Licensure For State of Nevada required Pay Range: $27.02 - $48.55 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Baseline Medical

Virtual Nurse Practitioner VA DC MD

Posted on:

May 27, 2026

Job Type:

Active

Role Type:

Nurse Practitioner

License:

NP

State License:

Virginia

Baseline Medical PC provides in-home care supported by virtual clinicians, coordinating telehealth assessments and medical oversight alongside on-site nursing staff.

Benefits: • Bonus based on performance • Employee discounts • Flexible schedule Position Overview: The Virtual Nurse Practitioner (NP) provides medical oversight and telehealth assessments for patients receiving in-home care through Baseline Medical PC. Telehealth visits are conducted while a Registered Nurse is physically present in the patient’s home. The NP reviews RN-collected clinical data, performs virtual medical assessments, develops treatment plans, and provides medical decision-making and prescriptions in real time. This position operates on a scheduled availability model, rather than continuous visit volume. During assigned shifts, the Nurse Practitioner is compensated hourly for being available to support care and join telehealth visits as needed. Patient assessments occur intermittently and are compensated separately on a per-assessment basis. Patient volume is currently modest, with expected growth over time. This role is well suited for an experienced Nurse Practitioner who is comfortable practicing autonomously within a collaborative, hybrid virtual–in-home care model and values flexible, part-time virtual work with predictable base pay. This role is a good fit if you: • Are comfortable with an availability-based workflow • Prefer thoughtful, quality-focused care over high-volume telehealth • Are seeking flexible, part-time virtual work • Enjoy collaborating closely with in-home nursing staff Compensation: Hourly Availability Rate: $50 per hour + Additional Per-Assessment Compensation This role is structured around scheduled availability rather than continuous visit volume. During assigned shifts, the Nurse Practitioner is compensated hourly for being available to support care and join telehealth visits as needed. Patient assessments occur intermittently and are compensated separately on a per-assessment basis. Patient volume is currently modest, with expected growth over time. Responsibilities: · Conduct real-time telehealth evaluations while a Baseline Medical RN is present with the patient in the home. · Review nursing assessments, vital signs, and clinical findings provided by the on-site RN. · Evaluate, diagnose, and manage acute and chronic medical conditions within Nurse Practitioner scope of practice. · Develop and communicate treatment plans, including prescribing medications, ordering labs, and recommending follow-up care. · Provide medical oversight and clinical direction to on-site nursing staff during patient encounters. · Ensure patient safety, appropriate escalation of care, and adherence to clinical protocols. · Document all patient encounters accurately, thoroughly, and in a timely manner within the electronic medical record (EMR). · Collaborate with clinical leadership and operations teams to ensure continuity of care and efficient workflows. · Utilize evidence-based guidelines and best practices in all clinical decision-making. · Participate in clinical meetings, quality improvement initiatives, and required training. · Maintain compliance with all state and federal regulations, including HIPAA and telehealth-specific requirements. · Maintain active and unrestricted licensure in all required jurisdictions. The ideal candidate will possess the following qualities: · Strong Clinical Judgment: Ability to independently assess patient conditions and make sound medical decisions in a virtual care environment. · Collaborative Mindset: Comfort working closely with on-site Registered Nurses to deliver coordinated, high-quality care. · Clear Communication Skills: Ability to provide concise, professional medical guidance to both patients and nursing staff during live encounters. · Organizational Strength: Ability to manage multiple virtual assessments efficiently while maintaining accurate documentation. · Patient-Centered Approach: Commitment to delivering compassionate, safe, and effective medical care. · Adaptability: Comfort working in a dynamic, seven-day clinical operation with varying patient needs. · Technical Proficiency: Confident use of telehealth platforms, EMRs, and clinical communication tools. Education/Experience Requirements: · Graduate of an accredited Nurse Practitioner program · National board certification (FNP, AGNP, or similar) · Minimum of 2 years of clinical experience in primary care, urgent care, or outpatient medicine · Active, unrestricted Nurse Practitioner licensure in Virginia, Washington DC, and Maryland or ability and willingness to obtain missing licenses within a defined timeframe. · Eligibility to practice as a W-2 employee under Baseline Medical PC Preferred Medical Experience: · Primary Care or Family Medicine · Urgent Care · In-Home or Mobile Medical Care · Telehealth / Virtual Care · Acute Illness Evaluation · Chronic Disease Management This is a remote position.

WelbeHealth

[Hiring] Telehealth RN Supervisor @WelbeHealth

Posted on:

May 27, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Not Specified

WelbeHealth is a value-based healthcare organization focused on improving outcomes for vulnerable seniors through programs including home-based primary care and telehealth services.

Role Description The WelbeHealth Advocate Supervisor, RN oversees the daily operations of the triage call center team, providing leadership and clinical guidance to RNs and LVNs to ensure timely, high-quality patient care and efficient call management. This role is accountable for process development and improvement, team management, staff scheduling, and training and development initiatives to support operational excellence and regulatory compliance. This role is different because the WelbeHealth Advocate Supervisor, RN at WelbeHealth: • Has the opportunity to lead and develop a fully remote team of RNs and LVNs, promoting flexibility and work-life balance while driving high-quality patient care. • Is part of a value-based care organization focused on improving patient outcomes through collaboration, innovation, and meaningful clinical impact. On the day-to-day, you will: • Lead the onboarding, training, coaching, and ongoing development of the WelbeHealth Advocate Nurses within the WelbeHealth Advocate Hub to ensure high-quality performance and engagement. • Oversee daily operations for the WelbeHealth Advocate Nurse team, including delegation of work, scheduling, and other duties required to meet the expected performance targets and goals, and service level expectations. • Identify systemic and operational issues and contribute to process improvement initiatives including root-cause analysis, solution implementation, and outcome monitoring. • Ensure team compliance with all organizational policies, regulatory requirements, performance standards, and departmental procedures. • Collaborate with cross-functional partners and market leaders as needed to resolve issues, improve coordination, and standardize processes across teams. Qualifications • Graduate of accredited school of nursing required; BSN required. • Unencumbered RN license required. • Minimum of five (5) years of nursing experience required, with at least two (2) years of experience in telehealth preferred. • Proficiency with technology, especially computers, software applications, and phone systems, including experience using electronic medical records systems. • Two (2) years of supervisory experience with demonstrated ability to mentor and develop team members. • Experience leading in a data-driven organization, leveraging reports and data to prioritize and manage people and projects. • Ability to work independently with minimal supervision and prioritize in a fast-paced environment. • Must be willing and able to work a varied schedule that may include evenings, nights, weekends, and overtime. Benefits • Medical insurance coverage (Medical, Dental, Vision). • Work/life balance - 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days. • 401K savings + match. • Comprehensive compensation package including base pay and bonus. • Additional benefits. Compensation Offering $109,240.54 — $144,197.50 USD COVID-19 Vaccination Policy At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. Our Commitment to Diversity, Equity and Inclusion At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. Beware of Scams Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment.

Progressive Technology

Telehealth Nurse - Remote Patient Care Coordination Roles

Posted on:

May 27, 2026

Job Type:

Active

Role Type:

Care Manager

License:

RN

State License:

Not Specified

A healthcare organization providing telehealth and remote nursing services, focusing on virtual patient care coordination and remote clinical support.

Job Summary Progressive Technology is seeking a compassionate and skilled Telehealth Nurse to join our team. In this fully remote role, you will be responsible for delivering high-quality patient care, coordinating healthcare services, and providing support to patients via virtual platforms. This position is ideal for registered nurses who have experience in patient care coordination and are passionate about leveraging technology to provide efficient, remote healthcare solutions. Key Responsibilities • * Conduct virtual patient assessments, including health evaluations and triage, to ensure optimal care delivery. • * Develop personalized care plans in collaboration with healthcare teams, ensuring all medical needs are met effectively. • * Provide ongoing care coordination by monitoring patient progress and adjusting care plans as needed. • * Educate patients and their families about disease management, treatment options, and healthy lifestyle choices. • * Ensure seamless communication with physicians, specialists, and other healthcare providers to deliver cohesive patient care. • * Record and maintain accurate patient information in electronic health records (EHR) systems. • * Offer emotional support and guidance to patients dealing with health issues, providing reassurance and answering medical questions. • * Stay updated with the latest telehealth practices, technologies, and healthcare regulations. • Required Skills and Qualifications • * Registered Nurse (RN) with a current license to practice in your state (or jurisdiction). • * Proven experience in nursing, with at least 2 years in patient care coordination, telehealth, or related fields. • * Excellent communication skills, both verbal and written, with the ability to interact professionally and empathetically with patients. • * Strong knowledge of healthcare systems, medical terminology, and telemedicine platforms. • * Ability to work independently and manage time effectively in a remote setting. • * Proficiency in using electronic health record (EHR) systems and telehealth technology. • * Ability to multitask and prioritize patient needs in a fast-paced virtual environment. • Experience • * A minimum of 2 years of clinical nursing experience, preferably in home care, care coordination, or telehealth. • * Previous experience in a virtual or telehealth nursing role is highly preferred. • Working Hours • * This is a remote, full-time position. • * Flexible working hours, including the possibility of night shifts or weekend hours depending on patient needs. • * Occasional on-call availability may be required for urgent patient care. • Knowledge, Skills, and Abilities • * Telemedicine proficiency: Skilled in using telehealth platforms and technology to assess and manage patient care. • * Care coordination: Experience in managing multidisciplinary care teams and advocating for patients. • * Clinical assessment: Strong ability to assess patient health, identify potential issues, and take proactive steps in care. • * Patient education: Ability to explain medical concepts clearly and teach patients about self-care, treatment plans, and prevention strategies. • * Problem-solving: Strong critical thinking and decision-making skills in providing virtual patient care. • * Time management: Ability to juggle multiple patient needs, prioritize tasks, and meet deadlines in a remote work setting. • Benefits • * Competitive salary: Offering an attractive pay scale based on experience. • * Comprehensive healthcare benefits: Including medical, dental, and vision coverage. • * Retirement plans: 401(k) with company match. • * Generous paid time off: Vacation, sick days, and holidays. • * Professional development: Opportunities for continuous learning, telehealth training, and certifications. • * Work-life balance: Flexible working hours with remote work options to accommodate personal schedules. • * Employee wellness programs: Access to mental health resources, wellness initiatives, and employee assistance programs (EAP). • Why Join Progressive Technology? Progressive Technology is committed to transforming healthcare through the power of telehealth. As a Telehealth Nurse, you will play a pivotal role in making healthcare accessible and convenient for patients in need of care. We offer a supportive work environment, opportunities for career growth, and the chance to make a significant impact in the healthcare industry. Join our dynamic team of professionals and be part of a forward-thinking company dedicated to delivering high-quality, remote healthcare. How to Apply Interested candidates are invited to submit their resume and a cover letter outlining their qualifications and experience. Please include any certifications relevant to telehealth or nursing. Submit your application through our online portal or email it directly to us.

Alignment Health

Remote-Manager, Case Management SNP (California RN License Required)

Posted on:

May 27, 2026

Job Type:

Active

Role Type:

Case Management

License:

State-Specific RN

State License:

California

Alignment Health is a healthcare organization focused on Medicare Advantage solutions, serving seniors and high-risk populations with care management and plan services.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Remote - Manager, Case Management SNP is responsible for the health care management and coordination of care for members with complex and chronic care needs. Assures compliance with SNP program requirements as outlined in the Model of Care. Monitors activities to support the timeliness of Health Risk Assessment (Initial and Reassessment) completion, Individualized Care Plan (ICP) development and Interdisciplinary Care Team (ICT) delivery for SNP members. Monitors and reports program performance, including vendor performance monitoring if activities are delegated. This position is responsible for the day-to-day operational performance of an integrated health management team while ensuring high-quality care management and adherence to regulatory and compliance standards for the appropriate program lines of business. California RN License Required Fully Remote | California Preferred (Outside Bay Area Preferred) Full-Time | Monday–Friday Make an Impact in Medicare Advantage Care We are looking for an experienced and compassionate healthcare leader to join our team as a Manager, Case Management – Special Needs Plan (SNP). In this fully remote leadership role, you will oversee a high-performing care management team dedicated to improving outcomes for members with complex and chronic healthcare needs. This is an exciting opportunity to lead meaningful work that directly impacts vulnerable populations while helping shape innovative care management strategies in a growing organization. If you are passionate about member advocacy, operational excellence, regulatory compliance, and developing strong clinical teams — we would love to hear from you. What You’ll Do As the Manager, Case Management – SNP, you will oversee day-to-day operations of an integrated care management team supporting Medicare Advantage SNP members. You will ensure compliance with CMS Model of Care requirements while driving quality, efficiency, and member-centered outcomes. Key Responsibilities • Lead, coach, and develop a high-performing case management team serving SNP members • Ensure timely completion of: • Health Risk Assessments (Initial & Reassessments) • Individualized Care Plans (ICPs) • Interdisciplinary Care Team (ICT) activities • Monitor operational and quality performance metrics and implement improvement strategies • Oversee regulatory audits, compliance initiatives, and quality assurance activities • Collaborate cross-functionally with: • Utilization Management • HEDIS/STARS • Quality Improvement • Provider and Clinical Operations teams • Analyze reporting trends and operational data to support strategic decision-making • Promote a culture of accountability, collaboration, and continuous improvement • Support program growth and operational excellence within the Medicare Advantage SNP population What You Bring: Required Qualifications • Active, unrestricted California RN license • Associate’s or Bachelor’s Degree in Nursing • Minimum 5 years of clinical case management experience • Minimum 1 year of experience supporting SNP programs within a health plan environment • Willingness to obtain RN licensure in additional company markets, if needed • Strong understanding of: • CMS SNP Model of Care • Medicare Advantage regulations • Care coordination and population health strategies Preferred Qualifications • BSN or MSN • 2+ years of leadership or supervisory experience in managed care or health plan operations • Case Management certification (CCM, ACM, or equivalent) • Experience with utilization review criteria such as MCG guidelines Skills for Success • Strong leadership and team development capabilities • Excellent communication and relationship-building skills • Data-driven mindset with the ability to analyze trends and drive performance • Experience working with EHR systems and healthcare technology platforms • Strong organizational, project management, and problem-solving abilities • Ability to thrive in a fast-paced, collaborative, remote environment Why Join Us? • Fully remote flexibility • Opportunity to lead and grow within a rapidly expanding organization • Meaningful work improving outcomes for high-risk Medicare populations • Collaborative, mission-driven culture focused on quality care and innovation • Ability to influence and enhance case management programs at scale • Competitive compensation and benefits package Physical Requirements Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the role. • Regularly required to communicate effectively via phone and video conferencing • Frequent sitting, standing, typing, and computer use • Occasionally lift and/or move up to 10 pounds • Close vision and ability to adjust focus required for computer-based work • Join a team that is committed to delivering exceptional care, improving member outcomes, and driving innovation in Medicare Advantage case management. Pay Range: $113,332.00 - $169,999.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. • DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.

Withings

Nurse Practitioner, Clinical Lead ACCESS PROGRAM (part time)

Posted on:

May 27, 2026

Job Type:

Active

Role Type:

Remote nursing leadership

License:

NP

State License:

Compact / Multi-State

Withings is a global connected-health company known for consumer health devices (blood pressure monitors, scales, sleep and activity trackers) that has expanded into virtual clinical care through Withings Medical Group and remote care programs.

About Withings Medical Group Withings is a global leader in connected health devices — from smart blood pressure monitors and scales to sleep and activity trackers. Withings Medical Group extends this mission into clinical care. The ACCESS program integrates device-generated data, AI-driven insights, and a dedicated virtual care team to manage cardiometabolic conditions — hypertension, dyslipidemia, CKD, obesity, and diabetes — meeting patients where they are, in their homes, across up to 50 states. The role in one sentence As our first clinical hire, you won't just fill a role — you will help shape it. This is a rare opportunity for a forward-thinking NP to work at the intersection of virtual care, digital health, and value-based medicine, partnering directly with the Medical Director to build the workflows, protocols, and care standards that will define how ACCESS delivers outcomes at scale. This is a part-time 1099 independent contractor role, designed to convert to a full-time salaried position as the ACCESS program scales. We expect this transition to occur as the program grows toward 1,000+ patients, contingent on program growth and mutual fit. What You'll Do Clinical care • Conduct virtual medical evaluations via video, phone, and asynchronous forms — confirming diagnoses, assessing for target organ damage, and documenting baseline metrics • Create and manage holistic, evidence-based care plans for patients with ACCESS-defined conditions: obesity, dyslipidemia, hypertension, ASCVD, mild-to-moderate CKD, and pre/diabetes • Act as the primary prescriber in Full Practice Authority states, including medication titration and renewal per clinical protocol. In non-FPA states, prescribe under Collaborative Practice Agreements with the Medical Director • Manage device-triggered Red Alerts (e.g., BP >180/110) — triaging patients for ER referral or immediate titration adjustment during business hours • Provide warm handoffs to referring clinicians in urgent situations, including new renal failure presentations Documentation & risk capture • Document all patient interactions — synchronous and asynchronous — in the EHR with accurate ICD-10 coding • Capture comorbidities accurately (e.g., CKD Stage 3b) to ensure correct reimbursement at the CKM rate rather than the standard eCKM rate • Prepare PCP care coordination reports to maintain the ACCESS-model partnership with referring physicians Program building • Collaborate with the Medical Director to develop and refine evidence-based titration algorithms and clinical protocols • Contribute to building scalable workflows that can support rapid patient volume growth • Provide feedback on app-based care tools, behavioral support content, and remote monitoring integration to continuously improve the patient experience Requirements What you'll bring • Active NP license in good standing in your home state; IMLC/eNLC compact license strongly preferred. Willingness to obtain licensure in target states within 90 days of start • Board certification through ANCC or AANP as a Family, Adult-Gerontology Primary Care, or Adult-Gerontology Acute Care NP • Minimum 2 years of post-licensure clinical experience in primary care, internal medicine, endocrinology, cardiology, or geriatrics with a strong command of cardiometabolic conditions • Demonstrated comfort with telehealth or digital care delivery — you thrive in a screen-based, asynchronous-forward environment • Strong documentation discipline and familiarity with EHR systems • Excellent independent clinical judgment — you are comfortable making decisions without a physician in the room • US residency (all 50 states and US territories) Bonus points for • Experience with value-based care, CMS quality measures, or ACO/care management programs • Familiarity with CKM (Cardiovascular-Kidney-Metabolic) conditions and GLP-1 therapy management • Comfort prescribing under Collaborative Practice Agreements in non-Full Practice Authority states • Spanish language proficiency — our platform serves both English and Spanish speakers • Prior experience building or launching a new clinical program or service line Benefits • Part-time 1099 contract to start, estimated at 20 hours per week, with a competitive hourly or project-based rate • A structured path to full-time conversion as ACCESS scales toward 1,000+ patients — this is a ground-floor opportunity, not a permanent contractor role • Open to candidates anywhere in the US — this role is fully remote. We have a preference for candidates based in or near Boston, as occasional in-office collaboration at our Boston headquarters is a plus, though not required • Direct access to senior leadership and real ownership over how ACCESS is built — your decisions will shape the program from day one • Upon conversion to full-time: full Withings benefits package including health coverage, 401(k) match, wellness reimbursements, and access to Withings products

CareScout

Registered Nurse RN (No direct care, assessments only)

Posted on:

May 27, 2026

Job Type:

Active

Role Type:

Clinical Reviewer

License:

RN

State License:

Not Specified

CareScout provides clinical assessment and care coordination services, conducting in-home and remote evaluations to support long-term care insurance and senior care needs.

Field Team Partner Opportunities supporting the Fremont, NE area. Flexibility, Greater Ease, Extra Hours RNs: Build a rewarding career and the lifestyle you want Are you a nurse looking for more flexibility, extra hours, or fulfilling work that doesn’t require hands-on care? CareScout’s Field Team independent contractor positions may be right for you. As a Field Team Partner, you’ll complete cognitive and functional assessments for older adults in their home. You decide which assessments and how many to take through a simple app. You can accept a case based on the time, place, and competitive fixed rates. Assessments are documented in an easy to use digital form. Your role will be to conduct assessments of long-term care insurance policyholders. The entire assessment usually takes 60‐90 minutes and includes: • Collecting information on the insured’s current and past medical history • Documenting the insured’s functional and cognitive levels • Administering a short cognitive exam • Leading the insured through a short demonstration activity Through the CareScout online portal, you can: • Complete online training • Accept or decline assessments opportunities • Complete the assessments, both online and offline • Check payment status of work completed To participate in CareScout’s Field Team Network, you’ll just need to: • Have a valid, current RN license, in good standing • Be technically savvy and have access to a laptop or tablet to perform the assessment in real time • Be willing to travel within 15 miles of your home or further Job Types: Contract, PRN, Per diem Medical Specialty: • Addiction Medicine • Allergy & Immunology • Anesthesiology • Bariatrics • Burn Care • Cardiology • Cath Lab • Critical & Intensive Care • Dermatology • Dialysis • Dietetics • Emergency Medicine • Endocrinology • Forensic Medicine • Gastroenterology • Genetics & Genomics • Geriatrics • Hematology • Holistic Medicine • Home Health • Hospice & Palliative Medicine • Hospital Medicine • Hyperbaric Medicine • Infectious Disease • Internal Medicine • Labor & Delivery • Medical-Surgical • Nephrology • Neurology • Nuclear Medicine • Ob/Gyn • Occupational Medicine • Oncology • Ophthalmology • Orthopedics • Otolaryngology • Pain Medicine • Pathology • Pediatrics • Perioperative Care • Physical & Rehabilitation Medicine • Plastic Surgery • Podiatry • Primary Care • Psychiatry • Public Health • Pulmonology • Radiology • Reproductive Endocrinology & Infertility • Rheumatology • Sleep Medicine • Sports Medicine • Surgery • Telemetry • Toxicology • Transplant Surgery • Trauma Medicine • Urgent Care • Urology • Wound Care Work Location: On the road

CORE Occupational Medicine

Remote Triage RN

Posted on:

May 27, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

CORE Health Networks is a provider of integrated occupational medicine services, offering employer-focused injury management, triage, and case management solutions to support workplace health and workers' compensation needs.

The Leading Provider of Integrated Occupational Medicine Services CORE Health Networks, the recognized leader in Integrated Occupational Medicine Services, provides integrated solutions to your occupational healthcare needs. Our programs are designed to align with each clients’ missions, goals, and values to achieve desired outcomes and exceed expectations. As we continue to grow, we are expanding our team of talented professionals. We are currently seeking a full-time Triage Registered Nurse to work from home. We have two openings on a Monday through Friday 9:30am to 6:00pm, Central Time work schedule. We offer a highly competitive total compensation package which includes Health, Dental, Vision, Life, 401(k), Six Paid Holidays, Vacation and Sick Leave, Long-term disability and short-term disability benefits, and much more. To learn more about this exciting opportunity, review the job specifications below: Position Overview: Under the direction of the Director of Injury Management, the Triage Nurse administers the intake of calls from contracted clients, an injured worker, Worker’s Compensation Insurance adjusters, Medical providers, and clinic staff. Provides exceptional service and quality treatment options to the patient and client throughout the injury management life-cycle. Principal Duties and Responsibilities (Essential Functions): • Triage injury/illness calls to determine if emergent/non-emergent • Determine if injury/illness requires immediate treatment or first aid advice • Research/locate the nearest facility to utilize for injury • Contact medical facility to determine the availability of adequate services to meet the needs of the particular injury/illness; Coordination of visit via phone/fax. • Speak with Medical personnel regarding the mechanism of injury/illness and discuss appropriate treatment pathways, obtaining UDS and BAT when applicable, and workplace accommodation availability. • Inform client/injured worker of name/location and contact information of medical facility available. • Notify appropriate contacts via email of injury/illness details with initial information within one hour of notification, unless an extreme situation. • Provide updates of diagnosis, work status, plan of care and follow up appointments to appropriate personnel with injured worker’s employer and adjuster. • Provide updates, diagnosis, clinic notes and treatment authorization requests to designated representative for client and Worker’s Compensation insurance adjuster. • Log injury/illness details on spreadsheet; Client specific • Bill time for each case according to services rendered. • Generating letters to providers, for clarification of work-relatedness and or treatment plan. • Obtaining and reviewing Medical records and diagnostics with relation to present injury/illness, prior history and/or forwarding to Specialty providers when allocated. • Proper documentation of phone calls made and received, interpretation of medical records from each exam, work status, and all emails transpired with regard to each case. • Assist Upper Management in CM activities as requested. • Answer phones in a professional manner when receptionist is not available. • Attend and participate in staff meetings. • Assists in office related tasks as needed. • Participate in opportunities for learning and skill maintenance/development, including internal and external training and workshops. • Other duties assigned by the supervisors. Licensures/Certification: • Must possess and retain a valid RN license for the state of LA (or compact multistate license). • Obtain a CWCP certification within two (2) years of employment. Experience: • Previous triage experience in ER or Urgent Care preferred; previous Occupational Health experience preferred • Minimum two (2) years practicing as a Registered Nurse Training: • Training for this position will be held primarily remotely, but may require in-office training at our corporate office depending on demands of training. IMPORTANT NOTICE: PLEASE ATTACH (ALL LICENSURES, CERTIFICATIONS, EDUCATION, AND DOCUMENTATION TO THE UPLOAD PORTION OF THE APPLICATION CORE, CHN, and our subsidiaries are Equal Opportunity Employers. EOE/ADAAA/AA. Applicants have rights under Federal Employment Laws. Please review the linked posters for more information: http://www.dol.gov/whd/regs/compliance/posters/fmla.htm https://www.eeoc.gov/employers/eeo-law-poster http://www.dol.gov/whd/regs/compliance/posters/eppa.htm

VHC Health

Virtual Nurse/Nursing Care Partner (Per-Diem)

Posted on:

May 26, 2026

Job Type:

Active

Role Type:

RN

License:

Compact RN

State License:

Compact / Multi-State

VHC Health is a healthcare organization providing hospital and outpatient services in Virginia, offering clinical and telehealth roles.

Position Title Virtual Nurse/Nursing Care Partner (Per-Diem) Job Description Purpose & Scope: Across inpatient Medical-Surgical, Telemetry, and Intermediate Care Unit (IMCU), the registered Virtual Nurse/Nursing Care Partner is responsible for the indirect nursing care of their assigned patients. The position requires knowledge of both department and hospital policies and procedures relevant to the delivery of nursing care. Interpretive skills, frequent interactive and consultative associations, are inherent in the position. The ability to retrieve, communicate or otherwise present information in a written, auditory or visual fashion is essential. The primary method to express or exchange ideas is through the spoken word. Written, telephone, and manual dexterity skills are required for this position. The Vitrual Nurse/Nursing Care Partner is expected to collaborate members of the healthcare team and communicate with patients via eremote technology in order to provide goal-directed care. The Virtual Nurse/Nursing Care partner will be completing tasks such as, but not limited to, patient admission assessments, patient education and discharge teaching via remote technology. Education: Bachelor's in Nursing Required, or Associate's in Nursing Required Experience: Two years of Nursing/Patient Care in an acute care setting is required, 5 years preferred Certification/Licensure: Licensed as a Registered Nurse by the Virginia Department of Health Professions required or, Compact State Licensure in Nursing required BLS certification required ACLS or PALS cards stand as showing competence in BLS Skills per American Heart Association Guidelines. If an employee holds current ACLS or PALS certification, this meets the requirement for BLS in their job description. They do not need to also carry a separate BLS certification. Skills Knowledge and Abilities Computer Skills: Typing Words per Minute 60+ Basic dysrhythmia knowledge, preferred Proficient with EHR systems, EPIC preferred

Baba

Nurse Practitioner - Remote 1099

Posted on:

May 26, 2026

Job Type:

Active

Role Type:

Nurse Navigator

License:

NP

State License:

Not Specified

Baba provides care navigation for older adults by pairing them with expert advocates—often nurses or social workers—who coordinate medical care, appeals, and social support through a telehealth-enabled platform.

Telehealth Nurse Practitioner | Remote 1099 | Structured Intake & Care Navigation About Baba Baba is rebuilding healthcare for older adults. Navigating healthcare can be overwhelming. By 2030, over 65 million older adults will make up nearly a quarter of the U.S. population, creating one of the largest and most urgent challenges in healthcare. Baba makes it easier by pairing older adults with an expert advocate (usually a nurse or social worker) who coordinates their care. Baba's insurance-covered advocates have supported thousands of families by writing insurance appeals, researching specialists, getting medical equipment and cheaper medications, and scheduling appointments. Baba's investors include General Catalyst, Genius Ventures, Soma Capital, and Ground Up Ventures, along with angel investors who were founders or executives of leading companies. More than 50% of the Baba team are former founders, with backgrounds from MIT, Carnegie Mellon, Stripe, Palantir, and Liquid AI. About the Role As an Intake Consultations Nurse Practitioner at Baba, you’ll perform brief, structured telehealth visits that establish medical necessity for our care navigation programs. These intake visits are the cornerstone of Baba’s service— identifying high-risk conditions, unmet social needs, and confirming eligibility for ongoing care navigation services. You’ll work with our care advocates and clinical operations team to ensure patients are enrolled safely, compliantly, and compassionately into the right level of support. This is a remote, 1099 (contractor) position, suitable for physicians seeking flexible, high-impact telehealth work. What You’ll Do • Conduct initiating visits. Perform telehealth-based E/M or Annual Wellness Visits (AWVs) to establish medical necessity for care navigation services and identify high-risk conditions or unmet social needs. • Document findings in Baba’s platform, ensuring accurate coding and use of SDOH Z-codes, diagnoses, and risk factors. • Validate care plans. Develop and approve individualized care plans to ensure alignment with the patient’s medical treatment plan and documentation of continued medical necessity. • Collaborate with advocates and nurse care managers to finalize individualized care plans aligned with each patient’s medical and social needs. What You Bring • Education: Completion of an accredited Nurse Practitioner program. (Required) • Licensure: Active Nurse Practitioner or APRN license, in good standing - licensed in multiple states. (Required) • Experience: 2+ years of experience in primary care, telehealth, or care management. (Required) • Familiarity with Medicare programs, including care navigation, incident-to requirements, and SDOH documentation. • Proficiency with EMRs, care management platforms, and telehealth workflows. Why Join Baba • Help shape a new model of integrated, tech-enabled care advocacy that unites clinical oversight with social support. • Work remotely and flexibly while ensuring patients receive high-quality care. • Join a mission-driven team building the care copilot that every patient deserves.

Doko Medical Inc

Telehealth Nurse Practitioner – Remote Weight Loss Care

Posted on:

May 26, 2026

Job Type:

Active

Role Type:

Nurse Practitioner

License:

NP

State License:

Compact / Multi-State

Doko Medical is a U.S.-based telehealth platform offering virtual primary and specialty care, currently expanding remote weight management and GLP-1 services.

Telehealth Nurse Practitioner (NP) – Weight Loss / GLP-1 Company: Doko Medical Website: https://doko.md Job Type: Contract (1099) Location: Remote – United States Schedule: Flexible Hours Compensation: Competitive per-consult or hourly compensation based on experience and state licensing About Doko Medical Doko Medical is a growing USA-based telehealth platform focused on accessible, patient-centered virtual care. We are expanding our remote weight management and GLP-1 services and are seeking experienced Nurse Practitioners licensed in multiple U.S. states to join our telehealth team. Our platform supports convenient online care with modern workflows, flexible scheduling, and streamlined telemedicine operations. Position Overview We are seeking motivated and clinically responsible Nurse Practitioners experienced or interested in medical weight management and GLP-1 therapies including semaglutide and tirzepatide. This is a fully remote telehealth role involving patient evaluations, follow-up care, medication management, and documentation through our online platform. Responsibilities • Conduct virtual patient evaluations for medical weight management • Review patient medical history, labs, medications, and contraindications • Develop appropriate treatment plans and determine eligibility for GLP-1 therapies • Prescribe medications when clinically appropriate and permitted by state regulations • Provide follow-up support and ongoing monitoring • Maintain accurate and timely documentation • Collaborate with the Doko Medical clinical operations team Requirements • Active Nurse Practitioner license in multiple U.S. states • Active NPI number • Experience in telehealth, primary care, family medicine, obesity medicine, or weight management preferred • Comfortable using telemedicine technology and EMR systems • Strong clinical judgment and communication skills • Must maintain active individual malpractice insurance coverage • Minimum malpractice coverage preferred: $1M/$3M Preferred Qualifications • Experience prescribing GLP-1 medications such as semaglutide or tirzepatide • Multi-state licensing strongly preferred • Experience with asynchronous telehealth workflows • Bilingual candidates are encouraged to apply What We Offer • Fully remote work environment • Flexible scheduling • Streamlined telehealth platform • Supportive and growing clinical team • Opportunity to help scale a modern virtual care platform • Consistent patient demand in a rapidly growing care category Apply Please submit: • Resume/CV • List of active state licenses • DEA status (if applicable) • Brief summary of telehealth or weight management experience Learn more about us at https://doko.md Pay: $86,839.98 - $104,581.48 per year Work Location: Remote

MPF Federal, LLC

Remote Telehealth RN Triage Military Families

Posted on:

May 26, 2026

Job Type:

Active

Role Type:

Triage

License:

Compact RN

State License:

Compact / Multi-State

MPF Federal, LLC is a healthcare services company that provides nursing and telehealth support, including roles serving military families and government health programs.

Position: Remote Telehealth RN Triage for Military Families Location: Danciger A healthcare organization is seeking Remote Telehealth Triage Nurses to support military families via a 24/7 Nurse Advice Line. This role enables RNs to leverage their acute care experience while providing guidance and health education from home. Candidates must have a minimum of 5 years of RN experience, a current Compact RN license, and a BSN degree. Enjoy a flexible schedule with competitive pay and a commitment to supporting licensure across all states. #J-18808-Ljbffr

UnitedHealthcare

Health & Social Services RN - Remote in Michigan

Posted on:

May 26, 2026

Job Type:

Active

Role Type:

Care Manager

License:

State-Specific RN

State License:

Michigan

UnitedHealthcare, part of UnitedHealth Group, is a large national health insurer and services company providing health plans, care management, and related healthcare services across the United States.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. In this autonomous Health and Social Services Coordinator role, you will be an essential element of an Integrated Care Model by relaying pertinent information about member needs and advocating for the best possible care available, and ensuring the members have the right services to meet their individualized needs. If you are located in the state of Michigan, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: • Analyze, assess, plan and implement care strategies that are adapted to the patient and directed toward the most appropriate, least restrictive level of care • Actively identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services • Act as a champion of member care plans throughout the continuum of care and act as a single point of contact • Confidently communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members • Courageously advocate for patients and families to ensure the patient's needs and choices are fully represented and supported by the health care team • Assess members' current health status by making outbound calls and receiving inbound calls • Recognize gaps or barriers in treatment plans • Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care • Manage the care plan throughout the continuum of care as a single point of contact • Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members • Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Registered Nurse license in the state of MI • 4+ years of clinical experience/community health in a healthcare setting • 2+ years of Case Management experience • 2+ years of Medicaid experience • 1+ years of experience working with MS Word, Excel and Outlook • Must reside in the state of Michigan Preferred Qualifications: • Certified Case Manager (CCM) • Experience working with the needs of vulnerable populations who have chronic or complex conditions • Experience with electronic charting • Experience with arranging community resources • Medicare experience • Experience or exposure to discharge planning • Experience in utilization review, concurrent review or risk management • Background in managing populations with complex medical or behavioral needs • Acute care experience • All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN

ReviveRX & Ways2Well

Remote Functional Nurse Practitioner - MUST be licensed in NY and NJ

Posted on:

May 25, 2026

Job Type:

Active

Role Type:

Nurse Practitioner

License:

NP

State License:

New York

ReviveRX & Ways2Well appear to be healthcare organizations offering virtual functional medicine and hormone optimization services, delivering patient care via telemedicine and digital health platforms.

Position Summary As a Nurse Practitioner, you will provide evidence-informed, patient-centered care via telemedicine. Your role involves conducting comprehensive health assessments, interpreting advanced lab results, designing personalized wellness and hormone optimization plans, and supporting patients through lifestyle and supplement-based interventions. You will collaborate with a multidisciplinary team in a fast-paced, fully virtual environment. Key Responsibilities • Conduct virtual consultations using both asynchronous and synchronous telehealth platforms • Review and interpret functional and traditional lab results (e.g., hormone panels, micronutrients, inflammatory markers) • Develop personalized care plans focusing on hormonal balance, metabolic health, nutrition, and preventive strategies • Educate patients on treatment options, supplement protocols, and lifestyle modifications • Document thoroughly and accurately in the EHR system (i.e., Charm or similar) • Collaborate with clinical support staff, pharmacists, and health coaches to ensure continuity of care • Adhere to state and federal telehealth regulations and best practices • Participate in ongoing training, case reviews, and team huddles to support professional development and care quality Required Qualifications • Active and unencumbered Nurse Practitioner license • National certification (e.g., AANP, ANCC) • Active DEA • Minimum of 2 years of NP experience, with exposure to functional, integrative, or hormone therapy preferred • Strong knowledge of hormone replacement therapy (HRT) (testosterone, estrogen, thyroid), peptides, and targeted supplementation preferred • Prior experience in a telehealth or digital health setting is strongly preferred • Comfortable navigating EHRs, telemedicine platforms, and cloud-based tools • Exceptional communication, patient engagement, and clinical documentation skills Work Environment & Physical Requirements • Primarily clinic/office-based setting for telehealth visits • Remote work environment; home office or dedicated workspace required • Must be able to work independently with minimal supervision • Virtual meetings via video conferencing (camera on expected) • Reliable high-speed internet connection required • Must maintain a distraction-free, professional background for video calls • Schedule: Monday - Friday, 8am-5pm Central $130 - $135 a year

Amerit Consulting

Telehealth RN: Remote Patient Care & Adherence

Posted on:

May 25, 2026

Job Type:

Active

Role Type:

Care manager

License:

State-Specific RN

State License:

North Carolina

Amerit Consulting is a healthcare consulting and staffing firm that places clinical professionals in contract, telehealth, and onsite nursing roles.

Amerit Consulting is seeking an experienced Telehealth Nurse for a 3-month assignment in Cary, NC, with potential for extension. The role requires an active RN license in North Carolina and at least 5 years of nursing experience. Responsibilities include patient education on medications, compliance documentation, and support in telehealth environments. The position offers a pay rate of $40 per hour and a schedule of Monday to Friday, 9 AM to 6 PM. Hybrid work eligibility is available after performance metrics are met. #J-18808-Ljbffr Amerit Consulting

Fountain Vitality, Inc.

Remote Registered Nurse with compact license

Posted on:

May 25, 2026

Job Type:

Active

Role Type:

Triage

License:

Compact RN

State License:

Compact / Multi-State

Fountain Vitality, Inc. is a telemedicine company offering concierge hormone replacement (TRT/HRT) and GLP-1 services to patients across multiple U.S. states via remote clinical teams.

Hi, we’re Fountain Vitality – a telemedicine company looking for registered nurses to join the medical team. We offer concierge TRT/HRT & GLP-1 telehealth treatment to our thousands of happy members around the United States. Fountain launched in 2021, and we are growing extremely fast (while delivering a higher-quality, more concierge experience than almost anyone else). In fact, we have one of the highest Trustpilot ratings (4.9 stars out of 5) in the United States for a telemedicine company, because we go above and beyond to deliver the best possible experience, unlike any others. That’s where you come in. The registered nurse will work as part of the clinical team, including physicians, nurse practitioners, & medical assistants, in a remote setting. This is a chance to support patients on hormone replacement therapy. The work is incredibly rewarding—many have told us our programs are "life-changing." This role is fully remote, so you can work from anywhere in the United States and enjoy the flexibility and lifestyle that a startup environment offers. We especially seek registered nurses living in RN "compact" states, as we currently serve about 35 states. Licenses in California and New York are particularly preferred. Role Overview: The registered nurse job duties will include coordinating labs, triage dosing and side effects, reviewing documentation, assisting providers, communicating with patients regarding prescriptions, providing patients with resource materials and answering patient questions, etc. A Bachelor of Science in Nursing is strongly preferred with a minimum of 2 years of RN experience. The ideal candidate will have strong communication skills and the desire to collaborate with others on this fast-growing team. Who We Are Looking For: At Fountain, we go above and beyond with service. Our goal is to delight our potential patients and relieve them of the normal headaches of traditional healthcare (ie. sitting in waiting rooms & waiting weeks just to schedule a visit). We’re focused on offering the highest quality telemedicine experience – never cutting any corners. That’s why a critical element we’re looking for is a positive attitude and a serious desire to make our patients feel like they’re in good hands. Someone who always goes the extra mile. What Makes Fountain A Great Place To Work: At Fountain, you’ll join our small team of medical specialists and entrepreneurs. You’ll benefit from our technology and operations team working to continually improve the experience, both internally and externally – as we’re a startup. Responsibilities: • Job duties will include coordinating labs, triaging, documentation review, assisting the providers, communicating with patients regarding prescriptions, providing patients with resource materials, answering patient questions, etc. • Provide feedback on documentation, systems, and operational processes so that we can efficiently and effectively keep growing • Go above and beyond to make our patients feel like they’re in good hands • Hours: 35-40 hours per week Requirements: • Live within an RN licensing compact state • Active California and/or New York license highly preferred • Exceptional communication skills • Growth mindset Benefits: • Availability and freedom to set an individual schedule as desired • Work 100% remotely • Competitive salary (Starting pay $35 an hour). • Start-up lifestyle (no corporate hospital bureaucracy) with high empathy for clinician experience • Energetic team with proven track record Fountain Wellness is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, age, disability, or veteran status. If you're curious about us, you can see our website at FountainTRT.com – this is our men’s health branch. You can also hear directly from our members by viewing the testimonials and reviews on our TrustPilot here: trustpilot.com/review/fountaintrt.com Job Types: Full-time, Contract Pay: From $35.00 per hour Application Question(s): • Please provide a contact email. • Please list all states where you hold an active registered nurse license. • Can you describe your nursing background and the patient populations you have worked with? • When can you start? • Do you have an RN compact license? If yes, which state? • Can you work the following shift- Friday, Saturday, Monday, Tuesday 9a-7p EST. Days off-Wednesday, Thursday and Sunday. Experience: • Registered Nurse: 1 year (Required) License/Certification: • Registered Nurse License (Required) Work Location: Remote

CVS Health

Case Manager RN, Compact License (Remote EST & CST)

Posted on:

May 25, 2026

Job Type:

Active

Role Type:

Case Management

License:

Compact RN

State License:

Compact / Multi-State

CVS Health is a large integrated healthcare company operating retail pharmacies, MinuteClinic walk-in clinics, pharmacy benefit management, and health services aimed at improving consumer access to care.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Overview Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country. Family Summary/Mission Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities. Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies. Position Summary/Mission Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes. Fundamental Components & Physical Requirements • Schedule: Monday-Friday 8AM - 5PM ET • Active and unrestricted NJ/Compact License • Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate. • Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care. • Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services. • Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. • Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person. • Prepares all required documentation of case work activities as appropriate. • Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes. • May make outreach to treating physician or specialists concerning course of care and treatment as appropriate. • Provides educational and prevention information for best medical outcomes. • Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. • Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data. • Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration. • Monitors member/client progress toward desired outcomes through assessment and evaluation. Required Experience • Active and unrestricted NJ/Compact License • Minimum 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members. • Minimum 2+ years CM, discharge planning and/or home health care coordination experience Preferred Experience • Bilingual preferred - Spanish • Certified Case Manager is preferred. • Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required Education • Associates Degree or Nursing Diploma Required • Bachelors Degree Preferred Anticipated Weekly Hours 40 Time Type Full time Pay Range The Typical Pay Range For This Role Is $66,575.00 - $142,576.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great Benefits For Great People We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 05/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

American Addiction Centers

Registered Nurse (RN) -Pre-Admission Testing

Posted on:

May 25, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Not Specified

Advocate Health (Advocate Aurora Health/Atrium Health) is a large nonprofit integrated health system operating hospitals and clinics across multiple states, offering clinical services and employment for a broad range of healthcare professionals.

Department: 37716 AMC Grafton - Preadmission Assessment Status: Part time Benefits Eligible: Yes Hours Per Week: 20 Schedule Details/Additional Information: • 0.5 FTE • Working hours between 0800-1630, 5 days in a pay period (3 days one week/2 days other week) • Remote • No weekends, no holidays, no call Pay Range $38.20 - $57.30 Registered Nurse (RN) – Pre Admission Testing Grafton, WI, United States Be the Nurse Who Redefines Care. At Advocate Health, being a nurse means more than delivering exceptional clinical care—it means leading with purpose, compassion, and boldness. As part of our One Advocate Nurse community, you’ll join a unified team committed to lifting others up, embracing innovation, and creating inclusive spaces where everyone can thrive. You’ll be empowered to think boldly, collaborate with humility, and drive change through fearless curiosity. Whether you're at the bedside, in the community, or advancing care through research and education, you’ll help shape the future of health—because here, we’re redefining care for you, for us, for all. Your feedback matters. Every nurse’s voice is vital in shaping our culture and improving care. We value your insights and experiences because they help us grow stronger together Where You Will Work: Join the Pre-Admit Testing team at Aurora Medical Center Grafton, where you will play an important role in preparing patients for their upcoming surgical experience through the first phone call and pre-procedure coordination. This is typically a remote position. The department supports patients across the Main OR, GI, Anesthesia, MRI, and Radiology areas and is staffed by a collaborative team of 4 RNs and 1 HUC each day. New team members can expect a thoughtful 3-month orientation, schedules planned 2 months in advance, and a welcoming culture built on daily communication, teamwork, and strong support among nurses and HUCs. We’re Looking For: • Completion of an accredited or approved program in nursing • Registered Nurse license issued by the state in which the teammate practices • Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association • The ideal candidate will have previous preadmit or surgical services experience. What You’ll Do: • As a skilled and compassionate RN, you will play a pivotal role in providing and coordinating comprehensive patient care through the nursing process to deliver safe, therapeutic care in accordance with established standards, policies, and procedures. • Using evidence-based practice, clinical decision making, compassion, and skills communication while leading efforts to create the safest patient environment and the best patient experience across the continuum. About This Location: Aurora Medical Center - Grafton a 132 bed facility is recognized as a leading destination for healthcare, offering private patient rooms, comfortable family areas, and a comprehensive selection of specialized services. Supported by a team of more than 450 Nurses, Grafton provides thoughtful amenities such as tranquil meditation gardens and a welcoming cafeteria, all designed to enhance comfort and peace of mind. With a strong focus on accessibility and advanced technology, the facility is preparing for a significant expansion, with a new patient tower scheduled to open in 2027. In addition to its core departments, Aurora Medical Center - Grafton delivers exceptional care in cardiovascular health, women’s services, orthopedics, emergency medicine, surgery, and neuroscience. The hospital’s commitment to professional development, state-of-the-art equipment, and diverse campus resources reflects its enduring tradition of compassionate, community-oriented care. Join our Grafton team today for a rewarding future in a supportive growing facility. Ready to Take the Next Step: Apply Now! This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation • Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training • Premium pay such as shift, on call, and more based on a teammate's job • Incentive pay for select positions • Opportunity for annual increases based on performance Benefits and more • Paid Time Off programs • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability • Flexible Spending Accounts for eligible health care and dependent care expenses • Family benefits such as adoption assistance and paid parental leave • Defined contribution retirement plans with employer match and other financial wellness programs • Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

Cigna Healthcare

RN - Oncology Nurse Case Manager - Remote

Posted on:

May 24, 2026

Job Type:

Active

Role Type:

Case Management Nurse

License:

RN

State License:

Not Specified

Cigna is a global health services company; Evernorth is Cigna's health services division offering pharmacy, care, and benefit solutions to improve health outcomes and access to care.

The RN Case Manager plays a critical role in delivering Cigna’s whole‑person health strategy by serving as a trusted advocate and clinical partner for customers, families, and caregivers. This role focuses on care coordination, customer engagement, and health navigation to improve outcomes and deliver exceptional customer experience. The Case Manager demonstrates Cigna’s Care Solutions cultural beliefs, acting with accountability, collaboration, compassion, and innovation in support of both customer needs and business objectives. How You’ll Make an Impact • Partner with customers to assess needs, develop individualized care plans, and document interventions and outcomes in Cigna medical management systems. • Collaborate with customers and providers to establish goals, interventions, and evidence‑based plans of care. • Apply motivational interviewing, behavior change strategies, and shared decision‑making to drive engagement and improved health outcomes. • Empower customers to effectively navigate the healthcare system and communicate with providers. • Coordinate care across customers, caregivers, providers, and internal partners via phone and digital channels (email, text, chat). • Collaborate with interdisciplinary teams—including pharmacists, nutritionists, behavioral clinicians, Medical Directors, and Medical Management programs—to support whole‑person health. • Track, analyze, and document daily activity, volume, and outcomes to support performance and quality goals. • Follow established policies, procedures, and Case Management performance measures. • Efficiently navigate multiple systems and applications in a fast‑paced, customer‑focused environment. • Complete required training and maintain clinical knowledge, licensure, and certifications. Required Qualifications • Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory. • Minimum of two (2) years of full‑time direct patient care experience as an RN. Preferred Qualifications • Specialty case management experience, with Oncology experience preferred for specialty roles. • Ability to obtain a URAC‑recognized Case Management certification within four (4) years of hire. • Strong clinical judgment with the ability to assess risk, prioritize care, and act decisively. • Excellent verbal and written communication skills across phone and digital platforms. • Proficiency in Microsoft Word, Excel, Outlook, and online research tools. • Demonstrated ability to resolve conflict, collaborate across teams, and interact with diverse populations. • Strong organizational skills, adaptability, and comfort managing multiple complex cases simultaneously. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Capital Staffing Solutions

Utilization Management RN – Remote (California Only)

Posted on:

May 24, 2026

Job Type:

Active

Role Type:

Utilization management nurse

License:

State-Specific RN

State License:

California

Capital Staffing Solutions is a healthcare staffing firm that places nurses and clinical professionals in temporary and permanent roles, including remote opportunities.

Utilization Management RN – Remote (California Only)Remote | Monday–Friday | Medicare Line of Business We are seeking an experienced Utilization Management Registered Nurse (RN) for a fully remote opportunity supporting a fast-paced Medicare Concurrent Review team. This position is ideal for nurses with a strong inpatient hospital background and prior utilization management/concurrent review experience who are looking to grow within a collaborative and highly respected healthcare organization. Responsibilities • Perform concurrent utilization reviews and determine medical necessity using evidence-based criteria • Apply MCG and/or InterQual guidelines • Review inpatient admissions and continued stays • Present cases to Medical Directors for review and determination • Coordinate discharge planning and transitions of care • Communicate with providers and internal clinical teams • Maintain quality and productivity metrics • Participate in staff meetings, huddles, and clinical rounds • Work within regulatory and CMS guidelines Required Qualifications • Active unrestricted California RN license • Minimum 5 years inpatient hospital bedside nursing experience • Minimum 2 years Utilization Management / Concurrent Review experience • Strong clinical judgment and critical thinking skills • Experience working in fast-paced healthcare environments • Strong computer skills and ability to navigate multiple systems/screens simultaneously • Excellent communication and time management skills • Dedicated HIPAA-compliant remote workspace with reliable internet connection Preferred Qualifications • ICU or ER nursing experience • Medicare utilization management experience • MCG and/or InterQual experience • Case management or discharge planning experience Preferred Clinical Backgrounds • ICU • ER • Med-Surg • Telemetry • Stepdown Schedule • Monday–Friday • 8:00 AM – 5:00 PM PST • Fully Remote (California residents only) Employment Type • Contract with chance to extend or hire • Long-term opportunity with potential for permanent conversion If you are an experienced RN with strong inpatient clinical experience and utilization management background, we encourage you to apply today for immediate consideration. #AJ1 Pay: From $45.00 per hour Benefits: • 401(k) • Dental insurance • Health insurance • Life insurance • Vision insurance Application Question(s): • Do you have ICU or ER Experience? Experience: • Inpatient Hospital Beside nursing: 5 years (Required) • Utilization Management / Concurrent Review: 2 years (Required) License/Certification: • CA RN License (Required) Work Location: Remote

Time Utilization Review Nurse

Part-Time Utilization Review Nurse (Remote – Nevada RN)

Posted on:

May 24, 2026

Job Type:

Active

Role Type:

Utilization Review Nurse

License:

State-Specific RN

State License:

Nevada

CCMSI is an employee-owned third-party administrator that handles workers' compensation claims and related services, offering clinical and administrative support to employers and providers.

Overview Part-Time Utilization Review Nurse – Remote (Nevada License Required) • Location: Remote (Reporting to Carson City, NV) • Schedule: Monday–Friday, 8:00 AM–12:00 PM PST • Compensation: $40,000–$45,000 annually (part-time, 20 hours/week) • Travel: Once per year to Carson City, NV • Reports To: Utilization Review Nurse Supervisor • Bring Your Nursing Expertise to a Flexible, Part-Time Role at CCMSI • At CCMSI, we don’t just process claims—we support people. As one of the largest employee-owned Third Party Administrators in the nation and a certified Great Place to Work®, we offer meaningful work, manageable caseloads, and a culture where your expertise matters. As an employee-owner, you’ll directly contribute to our success and share in it too. • Job Summary We’re seeking a Part-Time Utilization Review Nurse to conduct medical necessity reviews for treatment requests related to workers’ compensation claims. This role is fully remote (Nevada-based) and ideal for a nurse who thrives in a structured, detail-driven environment and enjoys applying clinical judgment to ensure quality, appropriate care. You will review provider-submitted treatment requests, apply evidence-based guidelines, and issue determinations in accordance with Nevada’s utilization review standards. • Responsibilities • Utilization Review concerns the quality of care provided to injured employees, including whether the service is appropriate and effective and the quality of treatment. Appropriate service is health care service that is medically necessary and reasonable, and based on objective, clinical findings. • Pursuant to the NAC 616C.123 (1), the criteria or guidelines used in the UR Plan, are consistent with the ACOEM Practice guidelines adopted as standards for the provision of accident benefits to employees who have suffered industrial injuries or occupational diseases. • Other Medical Criteria utilized include but are not limited to: • Official Disability Guidelines • The Medical Disability Guidelines • NCM/UR shall use the Guidelines as minimum standards for evaluating and ensuring the quality of programs of treatment provided the injured employee who is entitled to accident benefits. • Reports the diagnosis, ICD 9 code, medical appropriateness of the service, pertinent physical findings, diagnostic and therapeutic procedures, concurrent problems, follow‑up care and the injured employee's functional limitations. • Authorize a determination based on the health care service request reviewed; based on the information provided, meets or does not meet the clinical requirements for medical necessity and reasonableness of said service in accordance with appropriate medical guidelines. • The UR reviewer will process requests in accordance with the timelines specified in Nevada Revised Statute and Nevada Administrative Code. Qualifications • Qualifications (Required) • Active, unrestricted Nevada nursing license (RN). • Nursing degree (Associate’s or Bachelor’s). • Prior Utilization Review experience. • Strong clinical background; ability to evaluate complex medical information. • Excellent written and verbal communication skills. • High attention to detail with the ability to shift priorities as needed. • Proficiency with Microsoft Office and electronic documentation systems. • Nice to Have • Experience in trauma, orthopedics, occupational medicine, rehab therapy, med-surg, or workers’ compensation. • Exceptional organizational skills and the ability to work independently. • How We Measure Success • Timely and accurate utilization review determinations. • Responsiveness to internal and external stakeholders. • Quality, clarity, and compliance of documentation. • Annual Performance Evaluation. What We Offer • 4 weeks PTO + 10 paid holidays in your first year • Medical, Dental, Vision, Life, and Disability Insurance • 401(k) and Employee Stock Ownership Plan (ESOP) • Internal training and advancement opportunities • A supportive, team-based work environment • Compensation & Compliance The posted salary reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay. • Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. • ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. • Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency

Teladoc Health

Nurse, RX Fulfillment

Posted on:

May 24, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Not Specified

Teladoc Health is a global telemedicine and virtual care company that provides remote medical consultations, virtual care services, and digital health solutions.

Join the team leading the next evolution of virtual care. At Teladoc Health, you are empowered to bring your true self to work while helping millions of people live their healthiest lives. Here you will be part of a high-performance culture where colleagues embrace challenges, drive transformative solutions, and create opportunities for growth. Together, we’re transforming how better health happens. Summary Of Position The Nurse - RX Fulfillment (N-RXF) plays an integral part in ensuring superior care of patients treated through Teladoc. The N-RXF will apply professional knowledge in processing prescriptions ordered by Teladoc providers (either via phone or electronically), support Teladoc providers as dictated by established policies and guidelines and provide member support by phone or electronic messages. Essential Duties And Responsibilities • Deliver exceptional service to members, providers, care team members and external facilities representing Teladoc Health in a professional and courteous manner through a variety of communication channels including written, telephone, and video. (50%) • Apply professional knowledge to ensure prescriptions are processed accurately and in a timely manner using established protocols, guidelines, and provider communication • Communicate empathetically with members, using conflict resolution and service recovery skills as needed • Conducts health coaching related to Tobacco Cessation • Maintain detailed and accurate case documentation in the electronic health record • Manage daily assignment to meet department-specific performance metrics by applying clinical knowledge to support members with post-Teladoc visit needs (50%) • Works collaboratively and with appropriate clinical urgency to meet expected turnaround times • Maintain knowledge of Teladoc policies and prescribing guidelines • Analyze complex clinical situations and appropriately provide solutions based on established protocols and policies. • Review laboratory results and use established processes to escalate as needed • Maintain member confidentiality and adhere to all applicable regulations, including HIPAA The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs. Supervisory Responsibilities No Preferred Qualifications • BSN Preferred • Recent experience in the outpatient/urgent care setting preferred • Virtual work experience preferred. • Ability to work independently and as part of a high performing team. • Strong knowledge base of prescription medications • Demonstrated proficiency in mathematics, particularly with medication dosage calculations • Exceptional customer service skills. • Excellent written and verbal communication skills • Bilingual-Spanish Speaking a plus • Strong time management and organizational skills, with ability to effectively manage multiple, competing priorities. • Possess high degree of computer literacy and ability to manage multiple systems including Microsoft software. • Ability to work a flexible schedule including evenings, weekends, and holidays as assigned weekly based on business need. Required License Or Credential Needed To Perform Job • Active RN, BSN or MSN, NP in good standing. • 1-3 years of clinical experience. • Customer service experience in a health care setting. The above qualifications, knowledge, experience, and/or background are expected but not required for this role. The base salary range for this position is $80,000k-$88,000k. In addition to a base salary, this position is eligible for a performance bonus and benefits (subject to eligibility requirements) listed here Teladoc Health Benefits 2026. Total compensation is based on several factors including, but not limited to, type of position, location, education level, work experience, and certifications. This information is applicable for all full-time positions. We follow a Flexible Vacation Policy, intended for rest, relaxation, and personal time. All time off must be approved by your manager prior to use. You will also receive 80 hours of Paid Sick, Safe, and Caregiver Leave annually. This applies to full-time positions only. If you are applying for a part-time role, your recruiter can provide additional details. As part of our hiring process, we verify identity and credentials, conduct interviews (live or video), and screen for fraud or misrepresentation. Applicants who falsify information will be disqualified. Teladoc Health will not sponsor or transfer employment work visas for this position. Applicants must be currently authorized to work in the United States without the need for visa sponsorship now or in the future. Why join Teladoc Health? • Teladoc Health is transforming how better health happens. Learn how when you join us in pursuit of our impactful mission. • Chart your career path with meaningful opportunities that empower you to grow, lead, and make a difference. • Join a multi-faceted community that celebrates each colleague’s unique perspective and is focused on continually improving, each and every day. • Contribute to an innovative culture where fresh ideas are valued as we increase access to care in new ways. • Enjoy an inclusive benefits program centered around you and your family, with tailored programs that address your unique needs. • Explore candidate resources with tips and tricks from Teladoc Health recruiters and learn more about our company culture by exploring #TeamTeladocHealth on LinkedIn. As an Equal Opportunity Employer, we never have and never will discriminate against any job candidate or employee due to age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status, or pregnancy). In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind. Teladoc Health respects your privacy and is committed to maintaining the confidentiality and security of your personal information. In furtherance of your employment relationship with Teladoc Health, we collect personal information responsibly and in accordance with applicable data privacy laws, including but not limited to, the California Consumer Privacy Act (CCPA). Personal information is defined as: Any information or set of information relating to you, including (a) all information that identifies you or could reasonably be used to identify you, and (b) all information that any applicable law treats as personal information. Teladoc Health’s Notice of Privacy Practices for U.S. Employees’ Personal information is available at this link.

Lavender

[Hiring] Part-Time Behavioral Health RN @Lavender

Posted on:

May 24, 2026

Job Type:

Active

Role Type:

Behavioral Health Nurse

License:

Compact RN

State License:

Compact / Multi-State

Lavender is a healthcare company providing virtual behavioral health and telehealth services, hiring clinicians and operations staff to deliver remote care.

Role Description We are looking for a part-time Behavioral Health RN to join our Nursing Operations team. This role is perfect for someone with strong clinical expertise, crisis response skills, and a passion for client advocacy. As a key point of clinical support during scheduled coverage, you’ll play an important role in helping clients receive safe, timely, and effective care while contributing to operational excellence and a supportive client experience. This is a part-time role working a fixed Monday/Tuesday schedule, approximately 16 hours per week. What You’ll Be Doing • Clinical triage and client support • Respond to clinical questions and provide same-day nursing assessments when needed • Address pharmacist inquiries, clarify prescriptions, and manage medications per protocols • Support complex clients in completing standardized tools • Provide education to clients regarding medications and treatment plans • Support the response to client emergencies outside of scheduled appointments, triaging and escalating appropriately • Serve as a liaison between the Care Team and nursing staff to help resolve complex care matters or client complaints • Contact clients following discharge or intake, as needed, to ensure they have the right supports and referrals • Proactively contact clients to encourage engagement in care • Address client clinical care concerns directly and work to de-escalate situations as they arise • Monitor and complete assigned tasks within the EHR, CRM, and other communication platforms in a timely fashion per standards • Coordination of care and clinical operations • Collaborate with Lavender nurse practitioners to support seamless coordination of care as needed • Support critical incident response and debriefs in collaboration with clinical leadership • Provide oversight and follow-up for high-risk clients using dashboards and Lavender protocols • Perform key person interviews for collateral information to inform diagnosis, as appropriate • Support complex release of information requests • Support Care Circle operations to ensure smooth and efficient care • Coordinate care for hospitalized patients by supporting documentation, communication, and consultation with NP Managers when appropriate • Support post-acute transitions of care back to Lavender in collaboration with the broader clinical team • Quality assurance and process improvement • Support management of the clients of concern list, meetings, and follow-up actions, escalating to QI Council as appropriate • Document critical incident debriefs following Lavender’s SOP • Participate in Care Circle huddles, share process improvement suggestions, and support quality initiatives • Complete requested clinical audits on a regular basis and summarize findings accordingly Qualifications • Active, unrestricted compact RN license; ability to obtain additional state licenses as needed • Bachelor of Science in Nursing (BSN) • Minimum 3 years of clinical nursing experience, with at least 2 years in psychiatric or behavioral health settings • Demonstrated skill in triage, crisis response, and complex clinical decision-making • Experience with care coordination, hospital transitions, and interdisciplinary team collaboration • Strong communication and de-escalation skills, with experience supporting clients in high-stress or emotionally charged situations • Proven ability to manage competing priorities, maintain timely follow-up, and support quality improvement initiatives • Experience conducting chart audits, participating in quality programs, or contributing to compliance processes preferred • Comfortable working in a fast-paced, virtual care or telehealth environment • Availability to work a fixed Monday/Tuesday schedule, approximately 16 hours per week Benefits • Work for a company that is truly making a difference in the world • Remote work flexibility • A caring, spirited, and experienced team • An international work environment that embraces diversity and inclusion • Be part of a growing startup where you have the opportunity to help shape the company • In-person meetups • Competitive compensation Company Description Lavender believes that nurturing an environment where diversity and inclusion can thrive is critical to our success. We are proud to be an equal opportunity employer and do not discriminate on the basis of any status protected by law, including race, color, religion, sex, orientation, gender identity or expression, national origin, age, disability, or genetic information. If you need accommodation during the recruitment process, please reach out to people@joinlavender.com . For more about what it’s like to work at Lavender, see our careers page: https://www.joinlavender.com/careers .

4062 Aetna Resources, LLC

Case Manager Registered Nurse - Work At Home - San Antonio Texas

Posted on:

May 23, 2026

Job Type:

Active

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

CVS Health (Aetna Resources, LLC) is a large healthcare company offering pharmacy services, health insurance and employer-sponsored health programs; they hire clinicians for telehealth, care management and remote member services.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Remote Case Manager RN – Costco Team (San Antonio, TX) 100% Remote | Full-Time | Weekday Schedule Join our dedicated Costco Team as a Remote Case Manager RN and make a meaningful impact on members’ health and wellness from the comfort of your home. What You’ll Do As a Case Manager RN, you’ll play a vital role in improving health outcomes by: Assessing member needs and developing personalized care plans Coordinating care and connecting members with appropriate resources Identifying risks and removing barriers to better health Collaborating with multidisciplinary teams to drive positive outcomes Supporting members through telephonic and occasional virtual interactions What We’re Looking For - REQUIRED Active, unrestricted multi-state RN license in the state of residence 3+ years of clinical RN experience Comfort using multiple systems (Microsoft Office and other tools) Ability to work Monday–Friday, 8 AM–5 PM CST (with occasional 10 AM–7 PM rotation) Willingness to obtain additional state licenses (covered by employer) Associate degree in nursing Nice to Have Preference for those living within 45 minutes of San Antonio, TX Integrated case management experience Bilingual (Spanish/English) BSN Why Join Us? Fully remote flexibility Meaningful, patient-focused work Supportive team environment Opportunity to expand licensure at no cost Apply today to help drive healthier outcomes for members nationwide Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 06/06/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.

NYU Langone Medical Center

Telehealth Nurse Practitioner - Boynton Beach, FL (50/50 remote/in-office hybrid) - 8 hr Days

Posted on:

May 23, 2026

Job Type:

Active

Role Type:

Nurse Practitioner

License:

NP

State License:

Florida

NYU Langone Medical Center is an academic, integrated medical center in New York City within the NYU Langone Health system, providing clinical care, medical education, and biomedical research across multiple hospitals and clinics.

Position Summary: We have an exciting opportunity to join our team as a Telehealth Nurse Practitioner in Boynton Beach, FL. This role is a hybrid role which requires 50% of the time in office, and 50% remote. In this role, the successful candidate will be responsible for the provision, coordination, and assurance of comprehensive nursing care using nursing process and pertinent standards of care, the diagnosis of illness and physical conditions, and performance of therapeutic, corrective, and prescriptive measures of the designated inpatient or outpatient patient population within a collaborative practice agreement established with a specific physician working with the NYU Langone Health Clinical Access Center. Job Responsibilities: • Monitors and trends the cost effectiveness of the position, particularly as it relates to the efficiency and performance indicators established for the service • Supports the mission, philosophy, standards, goals and objectives of the institution and department • Plans and organizes care to meet individual patient needs and to ensure appropriate clinical resource utilization per protocols, pathways, and other means • Works collaboratively with the interdisciplinary team including the attending physician to develop and implement the therapeutic plan of care for the patient • Participates in the development and revision of interdisciplinary and nursing standards, patient and family education materials as relevant to area of practice and expertise. • Works collaboratively with the attending physician to maintain timely and appropriate communication with family members, house staff, other disciplines and ancillary services. • Works collaboratively with nursing leadership to ensure timely communications with the nursing staff • Demonstrates knowledge of the organization’s Service Standards and incorporates them into the performance of responsibilities • Participates in designated activities related to professional nursing standards and regulations of relevant outside agencies • Functions as a respectful member of the health care team. • Performs complete health history, physical examination and psychosocial assessment of patients within the designated practice or clinical unit • Orders customary laboratory, radiological and diagnostic studies per practice protocols, differentiates between normal/abnormal findings and follows protocols for abnormal findings, which may include referral to consulting physicians per customary pattern of the attending MD or with the collaborating physician • Formulates the plan of care, along with the attending physician, patient and family, based on expected goals of care • Works collaboratively with the attending physician, consulting physician(s), and other disciplines to identify, develop, and implement an appropriate plan of care that maximizes individual patient/family preference and enhances quality, access, and cost-effective outcomes • Prescribes in-patient and discharge medications according to New York State law, including controlled substances with DEA authorization • Prescribes medical equipment, devices, physical and occupational therapy, and home health services per practice protocol • Practices as a member of the allied health staff according to the rules and regulations of the Medical Staff and bylaws as outlined in the delineation of privileges • Evaluates treatment and health care plans for effectiveness and modifies per clinical standards and practice protocols, and considers needs and behaviors of specific patient age and cultural groups in all patient care • Promotes own professional growth and development in the clinical and managerial role • Maintains current expertise in area of practice • Serves as a clinical expert and resource for the education of peers and other health professionals • Participates in the development and monitoring of patient outcomes per established practice protocols for purposes of quality and performance improvement • Uses evidence-based health care literature to advise and support appropriate practice changes within the designated service • Works collaboratively with nursing and other disciplines in the development and implementation of clinical studies within the area of expertise • As needed, provides assistance to the Clinical Access Center staff by addressing patient medical advice messages or communicating test results to patients per provider instruction • Assists in the preparation, implementation, and evaluation of research protocols when applicable • Other duties as required Minimum Qualifications: To qualify you must have: • Licensure: Florida- Current registration as an Autonomous Nurse Practitioner, New York: Current registration as a Nurse Practitioner and Registered Nurse • Education: Master's Degree in Nursing • Written Collaborative Practice Agreement with an NYULH attending physician and credentialed through the Credentialing Committee of the Medical Board with Delineation of Privilege approved with role specific treatment privileges • Certification required (as soon as feasible following graduation from NP graduate program) by ANCC or Board Certification from other specialty organization that certifies Nurse Practitioners in a clinical area of practice • Competence: 1. At least five years of clinical nursing practice in the care of the patient population served; ability to apply nursing process toward achievement of specific outcomes in an organized fashion, which addresses patient/family safety and satisfaction. 2. Previous experience as a nurse practitioner is preferred. 3. Evidence of excellent interpersonal skills, effective communication skills, creative problem solving and excellent critical thinking and leadership. 4. Previously demonstrated ability to facilitate group processes and work cohesively and collaboratively as member of the interdisciplinary team 5. Effective change agent 6. Physical stamina, to perform responsibilities. Required Licenses: Autonomous Nurse Pract - FL, Registered Nurse License-NYS, Nurse Practitioner-NYS Qualified candidates must be able to effectively communicate with all levels of the organization. NYU Langone Florida provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents. At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family. NYU Langone Florida is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online. View Know Your Rights: Workplace discrimination is illegal." Remote Skills: American Nurses Credentialing Center (ANCC), Clinical Practices/Protocols, Clinical Trial, Communication Skills, Consulting, Cost Effectiveness Analysis, Drug Development, Health Plan, Healthcare, Home Care, Interpersonal Skills, Leadership, Medical Equipment, Medications, Nurse Practitioner, Nursing, Nursing Credentials, Occupational Therapy, Organizational Skills, Outpatient Care, Patient Assessment, Patient Care, Patient Education, Patient Safety, Performance Management, Philosophy, Physical Therapy, Physician Credential, Problem Solving Skills, Protocol Analysis, Registered Nurse (RN), Regulations, Research Protocols, Resource Utilization, Standards of Care, State Laws and Regulations, Team Player, Telehealth, Testing, Time Management, Treatment Evaluation, Treatment Plan, United States Drug Enforcement Agency (DEA) About the Company: NYU Langone Medical Center NYU Langone Medical Center, a world-class, patient-centered, integrated, academic medical center, is one of the nation’s premier centers for excellence in clinical care, biomedical research and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals: Tisch Hospital, its flagship acute care facility; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; Hassenfeld Pediatric Center, a comprehensive pediatric hospital supporting a full array of children’s health services; and the Rusk Institute of Rehabilitation Medicine, the world’s first university-affiliated facility devoted entirely to rehabilitation medicine--plus NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center’s tri-fold mission to serve, teach and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to NYULMC.org. Company Size: 10,000 employees or more Industry: Healthcare Services Founded: 1841 Website: http://www.med.nyu.edu

Molina Healthcare

Utilization Review Clinician (RN) - Must reside in IL

Posted on:

May 23, 2026

Job Type:

Active

Role Type:

Utilization Review

License:

State-Specific RN

State License:

Illinois

Molina Healthcare is a managed care organization that provides Medicaid, Medicare, and Health Insurance Marketplace plans and related services to individuals and families, focusing on government-sponsored healthcare programs.

SCHEDULE: Sunday, Monday, Tuesday, Friday 7:30 am to 6:30 pm. (Days off are Wednesday, Thursday, Saturday.) Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. • Analyzes clinical service requests from members or providers against evidence based clinical guidelines. • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. • Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. • Processes requests within required timelines. • Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. • Requests additional information from members or providers as needed. • Makes appropriate referrals to other clinical programs. • Collaborates with multidisciplinary teams to promote the Molina care model. • Adheres to utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Certified Professional in Healthcare Management (CPHM). • Recent hospital experience in an intensive care unit (ICU) or emergency room. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $27.73 - $54.06 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Lavender

Part-Time Behavioral Health RN

Posted on:

May 23, 2026

Job Type:

Active

Role Type:

Behavioral Health Nurse

License:

Compact RN

State License:

Compact / Multi-State

Lavender is a telehealth mental health company delivering virtual behavioral health services and clinical care coordination, employing clinicians and nurses to support remote psychiatric and wellness care.

Join the Lavender Team We are looking for a part-time Behavioral Health RN to join our Nursing Operations team. This role is perfect for someone with strong clinical expertise, crisis response skills, and a passion for client advocacy. As a key point of clinical support during scheduled coverage, you’ll play an important role in helping clients receive safe, timely, and effective care while contributing to operational excellence and a supportive client experience. This is a part-time role working a fixed Monday/Tuesday schedule, approximately 16 hours per week. The Opportunity The Behavioral Health RN provides both direct clinical support and coordination that ensures clients receive safe, timely, and effective care. You will serve as the primary point of response for clinical questions, emergencies, and complex client needs, while also facilitating smooth transitions of care during hospitalizations, discharges, and follow-up. Working closely with NPs, NP Managers, and the Care Team, you’ll help maintain high standards of quality and safety and contribute to a consistent and compassionate client experience What You’ll Be Doing Clinical triage and client support • Respond to clinical questions and provide same-day nursing assessments when needed • Address pharmacist inquiries, clarify prescriptions, and manage medications per protocols • Support complex clients in completing standardized tools • Provide education to clients regarding medications and treatment plans • Support the response to client emergencies outside of scheduled appointments, triaging and escalating appropriately • Serve as a liaison between the Care Team and nursing staff to help resolve complex care matters or client complaints • Contact clients following discharge or intake, as needed, to ensure they have the right supports and referrals • Proactively contact clients to encourage engagement in care • Address client clinical care concerns directly and work to de-escalate situations as they arise • Monitor and complete assigned tasks within the EHR, CRM, and other communication platforms in a timely fashion per standards Coordination of care and clinical operations • Collaborate with Lavender nurse practitioners to support seamless coordination of care as needed • Support critical incident response and debriefs in collaboration with clinical leadership • Provide oversight and follow-up for high-risk clients using dashboards and Lavender protocols • Perform key person interviews for collateral information to inform diagnosis, as appropriate • Support complex release of information requests • Support Care Circle operations to ensure smooth and efficient care • Coordinate care for hospitalized patients by supporting documentation, communication, and consultation with NP Managers when appropriate • Support post-acute transitions of care back to Lavender in collaboration with the broader clinical team Quality assurance and process improvement • Support management of the clients of concern list, meetings, and follow-up actions, escalating to QI Council as appropriate • Document critical incident debriefs following Lavender’s SOP • Participate in Care Circle huddles, share process improvement suggestions, and support quality initiatives • Complete requested clinical audits on a regular basis and summarize findings accordingly What You Bring • Active, unrestricted compact RN license; ability to obtain additional state licenses as needed Bachelor of Science in Nursing (BSN) • Minimum 3 years of clinical nursing experience, with at least 2 years in psychiatric or behavioral health settings • Demonstrated skill in triage, crisis response, and complex clinical decision-making • Experience with care coordination, hospital transitions, and interdisciplinary team collaboration • Strong communication and de-escalation skills, with experience supporting clients in high-stress or emotionally charged situations • Proven ability to manage competing priorities, maintain timely follow-up, and support quality improvement initiatives • Experience conducting chart audits, participating in quality programs, or contributing to compliance processes preferred • Comfortable working in a fast-paced, virtual care or telehealth environment • Availability to work a fixed Monday/Tuesday schedule, approximately 16 hours per week Why You Should Join Lavender • Work for a company that is truly making a difference in the world • Remote work flexibility • A caring, spirited, and experienced team • An international work environment that embraces diversity and inclusion • Be part of a growing startup where you have the opportunity to help shape the company • In-person meetups • Competitive compensation • Bring Your Whole Self to Work Commitment to Inclusion Lavender believes that nurturing an environment where diversity and inclusion can thrive is critical to our success. We are proud to be an equal opportunity employer and do not discriminate on the basis of any status protected by law, including race, color, religion, sex, orientation, gender identity or expression, national origin, age, disability, or genetic information. If you need accommodation during the recruitment process, please reach out to people@joinlavender.com. For more about what it’s like to work at Lavender, see our careers page: https://www.joinlavender.com/careers.

Medix™

Clinical Review RN - 249588

Posted on:

May 23, 2026

Job Type:

Active

Role Type:

Utilization review nurse

License:

State-Specific RN

State License:

New York

Medix is a healthcare staffing and workforce solutions company that provides talent acquisition, staffing, and consulting services to healthcare organizations and clinicians.

JOB TITLE: Clinical Review RN (Medicaid Cost Outlier) - Remote • **Must be licensed as an RN in NYS*** Nurse Background: 2+ years of acute care/medical surgical experience required. Utilization Review/Interqual/MCG experience a strong want. GENERAL RESPONSIBILITIES: This individual will complete the full spectrum of activities related to Utilization or Quality reviews as assigned. They will utilize their knowledge and expertise of the review program to conduct clinical level review, supporting Medical Review Analysts, and Physician Consultants to ensure an appropriate and accurate process. DUTIES: 1. Conduct utilization reviews up to and including the appeal level. This includes chart screen, complete electronic worksheets, enter required information and make level one denial decisions when necessary. 2. Conduct quality and clinical study data collection reviews. This includes chart review, complete detailed electronic data worksheets. 3. Act as a resource for the administrative staff in training, problem solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles. 4. Participate in collaborative training specific to clinical study objectives. 5. Other activities as may be deemed necessary. QUALIFICATIONS: 1. Licensed as a Registered Professional Nurse in New York State. 2. Knowledge and experience with electronic medical records including utilization, quality, and clinical charting. 3. Ability to oversee, problem solve and work collaboratively with peers, medical, analytical, and administrative support staff. 4. Excellent written and verbal skills. 5. Ability to work independently with little supervision. 6. Ability and desire to be flexible, innovative, and creative. EDUCATION & EXPERIENCE: 1. Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program and licensed to practice in the State of New York. 2. A minimum of 2 years experience in an acute care facility preferably in medical surgical and utilization review experience highly preferable. LOCATION: Remote, can sit anywhere as long as you are licensed as an RN in NYS SHIFTS: M-F, 40 hours or 4x10s (no weekends) PAY: $48-52/hr DURATION: long term open ended contract includes benefits, sick time, 401k, weekly pay

Care Access

Registered Nurse, Clinical Delivery – Remote, US

Posted on:

May 23, 2026

Job Type:

Active

Role Type:

Clinical Reviewer

License:

Compact RN

State License:

Compact / Multi-State

Care Access is a network of multi-specialty clinical research sites that partners physicians, nurse coordinators, and operations teams to expand patient access to clinical trials and support clinical research operations.

What We Do Care Access is a unique, multi-specialty network of research sites which operates as one connected team of physician investigators, nurse coordinators, and operations managers. Our goal is to engage every healthcare professional in clinical research and to make clinical trials a care option for every patient. By removing this bottleneck, Care Access is helping accelerate the approval and delivery of critical and life-saving therapies. Who We Are We care. Our people are the engines behind our mission: to revolutionize access to clinical trials for the benefit of patients everywhere. We care for one another, find new ideas to accelerate medicine, and seed a long-term impact for generations. Position Overview The Registered Nurse (RN) in this role will manage the communication of abnormal lab results to patients, ensuring compliance with state licensure requirements. This includes contacting patients, documenting communications, following up on lab escalations, and collaborating with providers to ensure all patient interactions are appropriately managed and documented. This role is critical in ensuring timely patient communication and maintaining compliance with clinical and legal standards. What You’ll Be Working On (Duties include but not limited to): • Receive and Review Lab Results from Pre-screening Program: Autonomously evaluate flagged abnormal, urgent, or critical lab findings to prepare them for patient communication, ensuring accuracy and timeliness. • Patient Communication: Proactively contact patients to discuss abnormal and critical lab outcomes. Ensure focused and uninterrupted communication, adhering to protocols while delivering only legally permissible information within the RN scope of practice. Use communication techniques to convey complex medical information clearly in a way non-medical patients will understand. Understand that the results shared with the patients may have serious health implications for them and relay them in a compassionate manner. • Patient Education: Develop and implement patient education initiatives to enhance understanding of lab result significance and promote informed decision-making. • Critical Thinking: Independently utilize critical thinking to assess the urgency and implications of abnormal and critical lab results, prioritizing patient communication based on clinical significance. • Documentation: Maintain comprehensive and precise documentation of communications in patient progress notes. Record abnormal and critical results, patient concerns, and subsequent actions. Ensure compliance with regulatory signature requirements. • Time Management: Exhibit exceptional time management skills to efficiently manage multiple lab results and patient communications, prioritizing urgent cases promptly. • Problem Solving Expertise: Apply advanced problem-solving abilities using medical training and experience to troubleshoot issues related to lab result discrepancies or data integrity. • Data-Driven Decision Making: Leverage data analytics to identify patterns and trends in lab results, contributing to evidence-based practice and enhanced patient outcomes. • Regulatory Knowledge: Maintain up-to-date knowledge of healthcare regulations and compliance standards to ensure all communications adhere to legal and ethical guidelines. • Escalation to Providers: For questions beyond the RN’s medical scope, escalate to a licensed, on call provider (NP/PA/MD/DO) and manage the completion of result delivery and accompanying required documentation. • Retention Team Escalations: Address lab-related escalations from the Retention Team, such as result clarifications, data discrepancies, or additional test requests, and communicate resolutions back to the patient, documenting the outcome. Physical and Travel Requirements • This is a remote position with less than 10% travel requirements. Occasional planned travel may be required as part of the role. • PTO and On-Call Coordination: Work within a structured on-call system to ensure coverage when team members are on leave. What You Bring (Knowledge, Skills, and Abilities): • Strong analytical capabilities, exceptional communication skills, and a commitment to fostering a patient centered environment. • Strong attention to detail and ability to manage multiple patients efficiently. • Ability to work independently while collaborating with a larger clinical team. • This role is pivotal in upholding clinical and legal standards through meticulous communication and patient care management. ○ • Precision in data analysis and documentation to ensure accuracy in lab results and reporting. Certifications/Licenses, Education, and Experience: • Education: • Active RN licensure with a commitment to compliance and regulatory standards. Compact Licensure required. Additional licenses may be required in addition. • BSN or equivalent degree preferred. • Experience: • Minimum of 3 years of experience as a working nurse, clinical research, medical communications, and/or related field. • Proficiency in Salesforce or other EMR systems for documenting patient interactions. • Licensure Requirement: Compact licensure required, non-compact state license preferred. Willingness to maintain and obtain additional state licenses as needed. Must hold all licenses in good standing. ■ Compact States [42]: RNs with compact licenses can practice in all 42 states in the compact, including Alabama, Arizona, Arkansas, Colorado, Florida, Texas, and more. ■ Non-Compact States [8]: California, Nevada, Illinois, Hawaii, Alaska, Oregon, Minnesota, New York. Benefits (US Full-Time Employees Only) • PTO/vacation days, sick days, holidays. • 100% paid medical, dental, and vision Insurance. 75% for dependents. • HSA plan • Short-term disability, long-term disability, and life Insurance. • Culture of growth and equality • 401k retirement plan Diversity & Inclusion We serve patients and researchers from diverse cultures and communities around the world. We are stronger and better when we build a team representing the people we aim to support. We maintain an inclusive culture where people from a broad range of backgrounds feel valued and respected as they contribute to our mission. We value diversity and believe that unique contributions drive our success. At Care Access, every day, we are advancing medical breakthroughs. We’re uniting standard patient care with cutting-edge treatments and research. Our work brings life-changing therapies to those in need and paves the way for newer and greater treatments to reach the world. We’re proud to advance these breakthroughs and work with the big players while engaging with the physicians and caring for patients. We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. Care Access is unable to sponsor work visas at this time. Employment Statement Care Access complies with all employment laws and regulations with respect to its employment practices, terms and conditions of employment, and pay equity and wages. Care Access does not engage in any unfair or forced labor practice and does not tolerate, under any circumstances, the use of any form of forced or involuntary labor, child labor, or human trafficking. This extends to suppliers, partners, or other third parties with whom Care Access does business. Care Access values and promotes the protection of human rights everywhere.

CVS Health

Registered Nurse Case Manager - LTSS - Work at Home

Posted on:

May 23, 2026

Job Type:

Active

Role Type:

Case Management Nurse

License:

RN

State License:

Not Specified

CVS Health is an integrated healthcare company operating pharmacies, retail clinics, pharmacy benefit management, and health services (including Aetna), offering a range of consumer and employer health solutions.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Case Manager RN is responsible for telephonic and/or face‑to‑face assessment, planning, implementation, and coordination of case management activities for members. The role evaluates members’ medical needs to promote overall wellness, improve short‑ and long‑term outcomes, and support appropriate, cost‑effective care delivery aligned with Aetna/CVS Health benefit plans and clinical policies. Required Qualifications • Registered Nurse (RN) with current, unrestricted state licensure (New York licensure required for NY backfill). • Minimum of 5 years of clinical practice experience. • Strong clinical assessment, critical thinking, and care coordination skills. • Effective written and verbal communication skills. • Ability to work independently in a telephonic/remote environment while collaborating effectively with cross‑functional teams. Preferred Qualifications • Prior case management, care management, or utilization management experience. • Experience working with Medicaid and/or LTSS populations. Education • Associates Degree in Nursing • Bachelor of Science in Nursing (BSN) Preferred Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $142,576.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 06/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Merakey

Remote RN: Clinical Triage & Patient Support (PRN)

Posted on:

May 23, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Not Specified

Merakey is a national healthcare organization providing behavioral health, intellectual/developmental disability, and community-based services across multiple U.S. locations.

A healthcare organization is seeking a Remote Registered Nurse to manage patient calls and monitor vital signs. This role requires an active RN license, experience in clinical decision making, and the ability to work remotely. The successful candidate will answer health-related inquiries, triage needs, and provide guidance based on vital alerts. This position offers flexibility for PRN shifts and is ideal for someone comfortable in a remote work environment.

Alignment Health

Inpatient Review Nurse (Remote, Must have California LVN / RN License)

Posted on:

May 22, 2026

Job Type:

Active

Role Type:

Utilization Review

License:

LPN/LVN

State License:

Compact / Multi-State

Alignment Health is a healthcare organization focused on serving seniors and medically complex patients, offering managed care and care coordination services.

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist patients through the continuum of care in collaboration with the patient’s primary care physician, facility case manager, discharge planner and employing contracted ancillary service providers and community resources as needed. Assure that services are provided at the most appropriate, cost effective level of care needed to meet the patient’s medical needs while maintaining safety and quality. Schedule: Monday - Friday, 8:00 AM - 5:00 PM Pacific Time (Required) GENERAL DUTIES/RESPONSIBILITIES: 1. Performs reviews of inpatients with complex medical and social problems. 2. Generates referrals to contracted ancillary service providers and community agencies with the agreement of the patient’s primary care physician. 3. Performs follow-up reviews and evaluations of patients in the ambulatory care or lower level of care setting. 4. Reviews inpatient admissions timely and identifies appropriate level of care and continued stay based on acceptable evidence-based guidelines used by AHC. 5. Effectively communicates with patients, their families and or support systems, and collaborates with physicians and ancillary service providers to coordinate care activities. 6. Identifies Members who may need complex or chronic case management post discharge and warm handoff to appropriate staff for ambulatory follow up, as necessary. 7. Communicates and collaborates with IPA/MG as necessary for effective management of Members. 8. Assigns and provides daily oversight of the activities and tasks of the CCIP Coordinator. 9. Records communications in EZ-Cap and/or case management database. 10. Arranges and participates in multi-disciplinary patient care conferences or rounds. 11. Monitors, documents, and reports pertinent clinical criteria as established per UM policy and procedure. 12. Monitors for any over utilization or underutilization activities. 13. Generates referrals as appropriate to the QM department. 14. Enters data as necessary for the generation of reports related to case management. 15. Reports the progress of all open cases to the Medical Director, Director of Healthcare Services and Manager of Utilization Management. 16. Performs other duties as assigned. Minimum Requirements: Experience: • Required: Minimum 3 years of general case management skills. Minimum of two years of experience utilizing Milliman Care Guidelines to justify Inpatient versus Observation Length of stay: including review of diagnosis and length of stay. Two consecutive years related experience in a managed care setting as an inpatient case manager • Preferred: Experience with a Senior population. Education: • Required: Successful completion of an accredited Licensed Vocational Nursing Program • Preferred: Associates or Bachelors Degree Specialized Skills: • Required: • Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. • Excellent critical thinking skills related to nursing utilization review • Knowledge of Medicare Managed Care Plans • Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; • Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly • Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. • Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. • Report Analysis Skills: Comprehend and analyze statistical reports. • Preferred: Knowledge and experience in complex/catastrophic case management preferred Licensure: Required: • Must have and maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact) • Immediately upon hire, must be willing to obtain LVN and / or RN licensure in Nevada, (Non-compact), Arizona (Compact), North Carolina (Compact), and Texas (Compact) which will be reimbursed by company. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1 While performing the duties of this job, the employee is regularly required to sit; use hands to finger, hand, or feel and talk or hear. 2 The employee is frequently required to reach with hands and arms 3 The employee is occasionally required to climb or balance and stoop, or kneel 4 The employee must occasionally lift and/or move up to 20 pounds. 5 Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Pay Range: $77,905.00 - $116,858.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. • DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.

Infomedia Group, Inc., dba Carenet Healthcare Services

Remote Telehealth RN - Bilingual EN/ES,Multi-State Licensed

Posted on:

May 22, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Infomedia Group, Inc., dba Carenet Healthcare Services, is a provider of nurse triage, care navigation, and telehealth services supporting healthcare organizations and patients remotely.

A healthcare service provider is seeking a Bilingual Registered Nurse (RN) to work from home. The nurse will conduct telehealth assessments, deliver patient care through phone or online interactions, and document interactions while monitoring performance metrics. Candidates should have a minimum of 3 years of direct patient care experience, an unrestricted RN license in the specified states, and must be bilingual in English and Spanish. An associate's degree in nursing is required, with a preference for a bachelor's degree.

Crawford Thomas Recruiting

Remote Neurology Telehealth Registered Nurse

Posted on:

May 22, 2026

Job Type:

Active

Role Type:

Care manager

License:

RN

State License:

Compact / Multi-State

Crawford Thomas Recruiting is a healthcare-focused recruiting firm that connects clinical talent with employers, often marketing remote and specialty nursing roles on behalf of client organizations.

Salary: $100,000–$120,000 & benefits-Fully Remote (U.S.) Job Summary: Our client is seeking an experienced Registered Nurse (RN) to lead and oversee care delivery operations supporting Principal Care Management (PCM) and Chronic Care Management (CCM) programs. This role will supervise nursing staff, maintain clinical quality standards, ensure Medicare compliance, and partner with neurology practices to deliver proactive, patient-centered care. Job Responsibilities: • Supervise and mentor LPNs supporting care coordination and patient engagement • Review and approve care plans and clinical documentation • Ensure quality assurance and compliance with Medicare PCM/CCM standards • Partner with neurologists and escalate clinical concerns as needed • Support workflow optimization and quality improvement initiatives • Engage patients and caregivers to ensure high-quality care delivery • Maintain accurate documentation and time-based billing compliance Qualifications: • Active, unrestricted RN license ( multistate preferred) • 2+ years of experience in chronic disease management, neurology, or care coordination • Experience supervising or mentoring clinical staff • Strong communication, leadership, and organizational skills • Experience with EMRs and digital health platforms • Preferred: PCM/CCM, Alzheimer’s, Parkinson’s, dementia, telehealth, and quality improvement experience About the Company: Our client is building a proactive healthcare model focused on neurodegenerative diseases, including Alzheimer’s. By partnering with neurologists and specialty clinics, they provide continuous patient support between visits through PCM and CCM programs. Backed by $8.5M+ in venture funding, they are redefining chronic care with a technology-enabled, patient-first approach.

GreenLife Healthcare Staffing

RN Clinical Reviewer / IDR - Remote to Office-Based Setting

Posted on:

May 22, 2026

Job Type:

Active

Role Type:

Clinical reviewer

License:

State-Specific RN

State License:

New York

Greenlife Healthcare Staffing is a nationwide healthcare recruitment agency that connects nurses and other clinicians with hospitals, clinics, nursing homes, and private practices.

RN Clinical Reviewer / IDR - Remote (#25310C) Location: Remote Employment Type: Full-time Hourly Rate: $50/hr About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Position Overview: Greenlife Healthcare Staffing is seeking an experienced Registered Nurse Clinical Reviewer (IDR) to join a remote position at a Non-profit organization located in New York. Responsibilities, focusing on conducting comprehensive medical-legal reviews and appeals for a respected non-profit organization. Why Join Us? • Competitive Compensation: $50/hr. • Comprehensive Benefits: • 1 Week of Paid Vacation based on accruals after 3 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment) • 6 Major Paid Holidays per year (after 3 months of employment) • 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act • License Reimbursement after 1 year of employment • Health insurance is subject to plan eligibility requirements • 401(k) Matching eligibility after 1 year of employment • Benefits from Paychex, such as Payactiv • GLHS is a great company to work for: 93% retention of employees 2 years+, Google reviews, great company culture, etc. • Work Schedule: Full-time • Professional Growth: Gain valuable experience in medical-legal review and dispute resolution • Impactful Work: Contribute to fair resolution processes in healthcare disputes Qualifications:• Education: Baccalaureate degree in Nursing or a graduate of an approved RN program. • Licensure: Current New York State RN license • Experience: • Must have at least 3 years of experience in a Med-Legal review setting. • Must have 1-3 years of experience in acute care utilization review/ appeals background. • Technical Skills: Experience with electronic medical records; strong research capabilities • Soft Skills: Excellent written/verbal communication; ability to work independently; flexible and innovative; meets deadlines in sensitive environments; strong collaborative and problem-solving skills Key Responsibilities:• Conduct reviews up to and including the appeal level. This includes chart screen, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations. • Act as a resource for the administrative and clinical staff in training, problem-solving, and clarifying determinations. Will provide technical assistance and conduct/participate in staff huddles. • Participate in collaborative training • Other activities as may be deemed necessary How to Apply: If you are ready to advance your career, we want to hear from you! Submit your Resume/CV to hr@glhstaffing.com or call our office at (800) 608-4025 to learn more about this opportunity. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives

Fira Health

Telehealth Nurse

Posted on:

May 22, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Not Specified

Fira Health is a healthcare organization offering telehealth and remote nursing services, including remote patient monitoring and home health support.

The Telehealth Nurse (RN/LVN) is responsible for providing remote clinical support, patient monitoring, triage, education, and care coordination for home health patients through telehealth and remote patient monitoring (RPM) programs. This role serves as the primary clinical contact for patients enrolled in telehealth services and plays a critical role in early identification of health concerns, intervention, prevention of hospitalizations, and improving patient outcomes. The Telehealth Nurse conducts virtual patient interactions, reviews RPM alerts and vital signs, documents all encounters in the EMR, escalates clinical concerns appropriately, and collaborates closely with field clinicians, physicians, and care coordination teams. Salary $80,000-$95,000 Key Responsibilities Remote Patient Monitoring & Virtual Care • Monitor daily patient biometric data including: • Blood pressure • Pulse oximetry • Weight • Blood glucose • Heart rate • Temperature • Review and respond to RPM alerts in a timely manner based on established clinical protocols. • Conduct scheduled and as-needed telehealth calls/video visits with patients and caregivers. • Identify early signs of clinical deterioration and intervene appropriately. • Provide ongoing chronic disease management support for conditions such as: • CHF • COPD • Diabetes • Hypertension • Post-hospital recovery • Reinforce physician orders, medication compliance, diet, and care plans during telehealth interactions. Patient Triage & Escalation • Perform remote nursing assessments and symptom triage. • Escalate urgent or worsening patient conditions to: • Physicians • Field Clinicians • Clinical managers • Emergency services when appropriate • Coordinate interventions to prevent avoidable ER visits and hospital readmissions. • Document all patient interactions, assessments, and escalations in the EMR. Patient Engagement & Education • Educate patients and caregivers on: • Use of telehealth/RPM equipment • Disease management • Medication adherence • Symptom monitoring • When to seek medical attention • Support patient engagement and encourage compliance with daily monitoring requirements. • Assist patients experiencing technology or connectivity challenges. • Build therapeutic relationships with patients through consistent communication and follow-up. Clinical Coordination • Collaborate with: • Home health nurses • Therapists • Physicians • Branch leadership • Intake and scheduling teams • Communicate significant patient status changes promptly to the care team. • Support continuity of care between hospital discharge and home recovery. • Participate in interdisciplinary case conferences as needed. Documentation & Compliance • Maintain accurate and timely EMR documentation for all telehealth encounters. • Ensure compliance with: • HIPAA regulations • Medicare and Medicaid guidelines • Home health documentation standards • Organizational telehealth policies • Follow established telehealth workflows and escalation protocols. Quality & Performance • Support organizational goals related to: • Reduction in hospital readmissions • Reduce LUPAs • Reduce missed visits • Improved patient satisfaction • Increased patient engagement • Better clinical outcomes • Meet productivity and responsiveness expectations for telehealth encounters and alert management. • Participate in quality improvement initiatives and telehealth program optimization efforts. Qualifications Education • Graduate of an accredited nursing program required. • Associate or Bachelor of Science in Nursing (ASN/BSN) preferred. Licensure/Certifications • Active and unrestricted RN or LVN/LPN license in the applicable state required. • BLS certification required. • Telehealth, case management, or chronic care management certifications preferred. Experience • Minimum 1–3 years of nursing experience required. • Experience in one or more of the following preferred: • Home health • Telehealth • Remote patient monitoring (RPM) • Care management • Chronic disease management • Post-acute care • Familiarity with EMR/EHR systems required. • Knowledge of Medicare home health regulations preferred. Required Skills • Strong clinical assessment and triage skills • Excellent phone and virtual communication skills • Ability to recognize early warning signs of patient decline • Strong documentation and organizational skills • Ability to multitask and manage high call volumes • Comfortable using telehealth platforms and digital health technology • Compassionate and patient-centered communication style KPIs / Performance Metrics • RPM alert response times • Patient call completion rates • Telehealth adherence and patient engagement • Reduction in avoidable hospitalizations/readmissions • Documentation accuracy and timeliness • Patient satisfaction scores • Escalation and intervention effectiveness • Decrease in LUPA rates • Decrease in missed visits • Productivity metrics (daily calls, monitored patients, completed follow-ups) Physical & Work Requirements • Prolonged periods of sitting and computer use. • Ability to work in a fast-paced remote monitoring environment. • May require evening/weekend rotation depending on patient coverage needs. • Remote or hybrid work environment may be available based on organizational needs.

Sutter Health

Clinical Triage Nurse, Work From Home

Posted on:

May 22, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

California

Sutter Health is a not-for-profit, integrated health system based in Northern California that operates hospitals, physician organizations, and other health services across multiple states.

We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone support to Sutter Health patients, other callers, in-basket and other remote support for physicians, and limited in-clinic support. Uses the nursing process, input from physicians, and Sutter Health's approved telephone nursing guidelines and protocols to maintain highly efficient operations, to provide quality care, and to ensure positive patient outcomes. Assesses patients' needs, appropriately dispositions cases, collaborates with the clinic and hospital-based providers to renew electronic prescriptions, identifies hospital and community resources, consultations and referrals, and preforms nursing follow-up activities. Clinical support includes assisting physician partners with message management and other communications within the electronic medical record (EMR) system, as well as limited patient care in an outpatient setting. Additional Requirements: DISCLAIMER 1 Applicants must be a resident of one of the following states to be eligible for consideration for this position: Utah, Idaho, Arizona, Arkansas, Louisiana, Tennessee, Missouri, Montana, or South Carolina. DISCLAIMER 2 This is a Work from Home position, therefore internet minimum speeds of 15 mbps download and 5 mbps upload are required. EDUCATION Graduate of an accredited school of nursing CERTIFICATION & LICENSURE RN-Registered Nurse of California (You can submit application without the CA RN license, but must acquire it prior to your start date if selected). RN-Registered Nurse in State of Residence PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN: 2 years' experience of practical nursing in a hospital, clinic, urgent care, or emergency room/department 2 years' experience with several specialties and subspecialties. OB/GYN experience preferred. SKILLS AND KNOWLEDGE Professional knowledge of clinical nursing protocols, regulations and institutional standards of care and risk management with an emphasis in the areas of disease processes, emergencies, health sciences and pharmacology. Advanced clinical knowledge of medical diagnoses, procedures, protocols, treatments, and terminology, including a working knowledge of state and federal regulations and guidelines. Solid analytical and project management skills, including the ability to analyze problems, situations, practices, and procedures, reach practical conclusions, recognize alternatives, provide solutions, and institute effective changes. Communication, interpersonal, and interviewing skills, including the ability to build rapport and explain medical lab results or sensitive information clearly and professionally to diverse audiences (patients). Proficient computer skills, including Microsoft Office Suite and experience working electronic medical/health records. Work independently, as well as part of a multidisciplinary team, while demonstrating exceptional attention to detail and organizational skills. Manage multiple priorities/projects simultaneously, sometimes with rapidly changing priorities, while maintaining event/project schedules. Recognize unsafe or emergency situations and respond appropriately and professionally. Ensure the privacy of each patient’s protected health information (phi). Analyze possible solutions using precedents, existing departmental guidelines and policies, experience and good judgment to identify and solve standard problems. Build collaborative relationships with peers, physicians, nurses, administrators, and public to provide the highest quality of patient care. SHIFT: There are 40hr, 32hr, 30hr, and 28hr per week shifts available. PAY: Starting wage is $37.19/hr + shift differential (non-negotiable) for the following states: Arizona, Arkansas, Idaho, Louisiana, Missouri, Montana, and South Carolina. Starting wage is $40.91/hr + shift differential (non-negotiable) for the following states: Colorado, Florida, Georgia, Illinois, Michigan, Minnesota, Nevada, North Carolina, Ohio, Oregon, Pennsylvania, Texas, and Virginia. Job Shift: Varied Schedule: Full Time Shift Hours: 8/10 Blended Days of the Week: Variable Weekend Requirements: Rotating Weekends Benefits: Yes Unions: No Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $37.19 to $48.71 / hour The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package. Working at Sutter Health Sutter Health values and supports the unique talents and strengths that each employee brings to our organization. As a result, you are empowered to apply your passion for healing in innovative ways to care for patients and their families.

Crossing Hurdles

Primary Care Nurse Practitioners (Remote)

Posted on:

May 22, 2026

Job Type:

Active

Role Type:

Triage

License:

NP

State License:

California

Crossing Hurdles is a global recruitment consultancy that connects employers with talent; this listing represents a telehealth primary care role placed for a digital healthcare platform.

Crossing Hurdles is a global recruitment consultancy firm that assists our clients to hire best talent. About The Company A fast-growing digital healthcare platform transforming outpatient care by making high-quality medical services simple, fast, and affordable. Led by the founders of a major healthcare venture acquired by a global tech leader, the organization is building the go-to destination for most non-emergency medical needs through clinical excellence and intuitive virtual technology. Position: Telehealth Nurse Practitioner Type: Part-time Compensation: Upto $75/hr Location: Remote (United States) Commitment: 20 hours/week Role Responsibilities • Deliver high-quality virtual care through triage, chat, and video consultations. • Assess and manage patients across a wide range of acuity and clinical complexity. • Coordinate expedited labs, imaging, referrals, and specialist input within the care network. • Utilize modern telehealth platforms to maintain clear, timely, and accurate documentation. • Support and guide clinical workflows, policies, and best practices across teams. • Adapt quickly to new tools, workflows, and next-generation digital health models. Requirements • Background in Family Medicine or Internal Medicine. • Minimum of 6,240 clinical practice hours (equivalent to 3 years full-time experience). • 5–10 years of total experience in Family or Internal Medicine. • 4+ years of telehealth experience. • Active U.S. medical licensure covering at least 40% of the U.S. population, including CA, TX, FL, and NY. • Prior leadership experience overseeing clinical teams, workflows, or policies. • Strong comfort with triage-based decision-making. • Fast learner with digital tools and remote care processes. • U.S.-based candidates only (visa sponsorship not available).

Westside Family Healthcare Inc

Nurse, Virtual RN *$5000 Signing Bonus*

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Triage

License:

Compact RN

State License:

Compact / Multi-State

Westside Family Healthcare is a community-based healthcare organization operating primary care health centers and a mobile unit serving patients across Delaware, focused on improving access to ambulatory and community health services.

Description WESTSIDE IS LOOKING FOR A NURSE / RN TO JOIN THE VIRTUAL NURSE TEAM! SIGN ON BONUS OFFERED! LOAN PAYOFF PROGRAMS AVAILABLE! Join our dedicated healthcare team as a nurse, where each day presents a new opportunity to make a significant difference in the lives of our patients. The Virtual RN is an experienced Registered Nurse (RN) working as part of a multidisciplinary team supporting general care processes, providers, and patients in an ambulatory community-based setting. The RN is responsible for evaluating and assessing patient’s health care needs based on nurse assessment, clinical judgment, nurse process and evidence-based clinical support tools. The RN will provide appropriate disposition and timely follow up, per telephone triage policy. The RN must meet minimum quality and productivity standards as defined by Westside Family Healthcare. Since opening our doors in 1988, Westside has been driven by our mission to improve the health of our communities by providing equal access to quality healthcare, regardless of ability to pay. With 240 team members, five health centers, one mobile health unit and over 27,000 patients all across Delaware, Westside is committed to improving health, one patient, one family, one community at a time. Our Mission: To improve the health of our communities by providing equal access to quality healthcare, regardless of ability to pay Our Vision: Achieve health access for all Our Values: • Compassion: Lead with compassion • Service: Serve with humility • Excellence: Be exceptional • Empowerment: Empower all people OUR BENEFITS: Our benefit package includes medical insurance, dental insurance, vision insurance, life and disability insurance, a 401(k) retirement plan with a match, and supplemental insurances. We offer a generous PTO package and flexibility to provide work/life balance. Westside Family Healthcare is an Equal Opportunity Employer that values diversity. RESPONSIBILITIES of the Virtual RN Nurse role 1. Provide telephonic clinical assessment, health education and utilization management services across the life span, 2. Care coordination for patients, including prior authorization; identifying and seeking solutions for barriers to care 3. Provide telephonic triage for patients seeking care with multiple complaints 4. Assessment and provision of care using telecommunication devices 5. Application of the nursing process in telehealth care 6. Delivery of culturally sensitive, age-specific care to identified populations 7. Use of clinical decision support tools 8. Provide effective therapeutic communication, counsel and crisis management 9. Handle multiple in bound calls and ability to complete out-bound calls 10. Other duties as assigned. Requirements • Graduate of an accredited college or school of nursing with an Associates’ degree in nursing • Active, unencumbered Registered Nurse licensure in the State of Delaware or compact state • Proficient with technology • Two years of work experience in an ambulatory care, emergency services, med/surg, and/or pediatrics Westside Family Healthcare is currently registered to employ remote workers in the following states: Arizona, Delaware, Maryland, North Carolina, Nebraska, New Jersey, Pennsylvania, Puerto Rico, Rhode Island, Texas, Virginia and West Virginia.

Freeman Health System

[Hiring] School Telehealth Nurse Practitioner @Freeman Health System

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Nurse Practitioner

License:

NP

State License:

Missouri

Freeman Health System is a regional healthcare organization providing hospital and outpatient services and community-based care.

Role Description The nurse practitioner will provide high quality healthcare services to patients through our school-based telehealth program. The NP evaluates, diagnoses, treats, and educates patients while collaborating with physicians and healthcare teams to ensure excellent patient outcomes. This role requires strong clinical judgement, technology skills, and the ability to build rapport in a virtual environment. Previous experience as a nurse practitioner is strongly encouraged. Qualifications • Current Missouri Advanced Practice Nurse licensure as a Nurse Practitioner according to MO State Board of Nursing. • Current Missouri Registered Nurse license or current Registered Nurse license from a compact state. If a compact license is held, it must be in the nurse’s state of residence. Benefits • Health, vision, dental insurance • Retirement with employer match • Wellness program with discounts to Health Insurance or Cash Bonus with Participation • Milestone payments with longevity of employment • Paid time off (PTO) • Disability pay • Daycare designated only for Freeman Family members • Payroll deduction at different locations such as The Daily Grind, Freeman Gift Shop, Cafeteria, etc. Company Description

SSM Health

Registered Nurse-Clinic - Phone Triage PRN

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

SSM Health is a large integrated health system operating hospitals and clinics across the U.S. Midwest, offering clinical care and health services including remote nursing roles.

It's more than a career, it's a calling MO-REMOTE Worker Type: PRN Job Highlights: Phone Triage RN- Clinic Remote - Supports (13) Pediatric Clinics Triage role performs essential clinical and operational functions, including: · Patient triage · Appointment scheduling · Fax folder management · Results management · Medication refills · Completion of forms · Outbound calls to patients with clinician guidance Job Summary: Provides direct nursing care in accordance with established policies, procedures and protocols of the healthcare organization. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES • Implements and monitors patient care plans. Monitors, records and communicates patient condition as appropriate. • Serves as a primary coordinator of all disciplines for well-coordinated patient care. • Notes and carries out physician and nursing orders. • Assesses and coordinates patient's discharge planning needs with members of the healthcare team. • May round with physician in an inpatient setting. • Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's Scope of Service. • As an SSM Health nurse, I will demonstrate the professional nursing standards defined in the professional practice model. Uses the ANA Code of Ethics for Nurses to guide his/her response to the current and evolving health and nursing needs of our patients and our patient populations. • Works in a constant state of alertness and safe manner. • Performs other duties as assigned. EDUCATION • Graduate of accredited school of nursing or education equivalency for licensing EXPERIENCE • No experience required PHYSICAL REQUIREMENTS • Constant use of speech to share information through oral communication. • Constant standing and walking. • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs. • Frequent sitting, reaching and keyboard use/data entry. • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors. • Frequent use of smell to detect/recognize odors. • Frequent use of hearing to receive oral communication, distinguish body sounds and/or hear alarms, malfunctioning machinery, etc. • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs. • Occasional lifting/moving of patients. • Occasional bending, stooping, kneeling, squatting, twisting, gripping and repetitive foot/leg and hand/arm movements. • Occasional driving. • Rare crawling and running. REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois • Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) • And • Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) State of Work Location: Missouri • Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) • And • Registered Nurse (RN) - Missouri Division of Professional Registration • Or • Registered Nurse (RN) Issued by Compact State State of Work Location: Oklahoma • Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) • And • Registered Nurse (RN) Issued by Compact State • Or • Registered Nurse (RN) - Oklahoma Board of Nursing (OBN) State of Work Location: Wisconsin • Basic Life Support HealthCare Provider (BLS HCP) - American Heart Association (AHA) • And • Registered Nurse (RN) Issued by Compact State • Or • Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services Work Shift: Day Shift (United States of America) Job Type: Employee Department: 7082000125 Sunset Hills Peds Scheduled Weekly Hours: 0 Benefits: SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs. • Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). • Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday. • Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. Explore All Benefits SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

FONEMED

Remote Telehealth Triage RN: Care & Decision Expert

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Triage

License:

Compact RN

State License:

Compact / Multi-State

FONEMED is a telehealth provider that offers remote clinical services, connecting nurses and clinicians with patients for phone-based triage and virtual care support.

A leading telehealth provider is seeking a Remote Telehealth Triage Nurse to provide telephone triage and health advice to patients across the United States. Candidates should have a compact nursing license and a minimum of 3 years clinical experience. This full-time position allows for flexible scheduling, and experience with electronic triage software is a plus. Join a company that values its staff and offers a collaborative work culture. Apply today to be part of an impactful team.

Sutter Health

Clinical Triage Nurse, Work From Home

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Sutter Health is a not-for-profit healthcare network operating hospitals, medical foundations, and outpatient services, primarily serving communities in California and nearby regions.

We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone support to Sutter Health patients, other callers, in-basket and other remote support for physicians, and limited in-clinic support. Uses the nursing process, input from physicians, and Sutter Health's approved telephone nursing guidelines and protocols to maintain highly efficient operations, to provide quality care, and to ensure positive patient outcomes. Assesses patients' needs, appropriately dispositions cases, collaborates with the clinic and hospital-based providers to renew electronic prescriptions, identifies hospital and community resources, consultations and referrals, and preforms nursing follow-up activities. Clinical support includes assisting physician partners with message management and other communications within the electronic medical record (EMR) system, as well as limited patient care in an outpatient setting. Additional Requirements: DISCLAIMER 1 • Applicants must be a resident of one of the following states to be eligible for consideration for this position: Utah, Idaho, Arizona, Arkansas, Louisiana, Tennessee, Missouri, Montana, or South Carolina. DISCLAIMER 2 • This is a Work from Home position, therefore internet minimum speeds of 15 mbps download and 5 mbps upload are required. EDUCATION • Graduate of an accredited school of nursing CERTIFICATION & LICENSURE • RN-Registered Nurse of California (You can submit application without the CA RN license, but must acquire it prior to your start date if selected). • RN-Registered Nurse in State of Residence PREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN: • 2 years' experience of practical nursing in a hospital, clinic, urgent care, or emergency room/department • 2 years' experience with several specialties and subspecialties. OB/GYN experience preferred. SKILLS AND KNOWLEDGE • Professional knowledge of clinical nursing protocols, regulations and institutional standards of care and risk management with an emphasis in the areas of disease processes, emergencies, health sciences and pharmacology. • Advanced clinical knowledge of medical diagnoses, procedures, protocols, treatments, and terminology, including a working knowledge of state and federal regulations and guidelines. • Solid analytical and project management skills, including the ability to analyze problems, situations, practices, and procedures, reach practical conclusions, recognize alternatives, provide solutions, and institute effective changes. • Communication, interpersonal, and interviewing skills, including the ability to build rapport and explain medical lab results or sensitive information clearly and professionally to diverse audiences (patients). • Proficient computer skills, including Microsoft Office Suite and experience working electronic medical/health records. • Work independently, as well as part of a multidisciplinary team, while demonstrating exceptional attention to detail and organizational skills. • Manage multiple priorities/projects simultaneously, sometimes with rapidly changing priorities, while maintaining event/project schedules. • Recognize unsafe or emergency situations and respond appropriately and professionally. • Ensure the privacy of each patient’s protected health information (phi). • Analyze possible solutions using precedents, existing departmental guidelines and policies, experience and good judgment to identify and solve standard problems. • Build collaborative relationships with peers, physicians, nurses, administrators, and public to provide the highest quality of patient care. SHIFT: • There are 40hr, 32hr, 30hr, and 28hr per week shifts available. PAY: • Starting wage is $37.19/r + shift differential (non-negotiable) Job Shift: Varied Schedule: Full Time Shift Hours: 8/10 Blended Days of the Week: Variable Weekend Requirements: Rotating Weekends Benefits: Yes Unions: No Position Status: Non-Exempt Weekly Hours: 40 Employee Status: Regular Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $37.19 to $48.71 / hour The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

Health Readiness Resources

Telehealth Nurse Practitioner/ PA (Virgin Islands Licensed)- Military Health Assessments

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Triage

License:

NP

State License:

U.S. Virgin Islands

Health Readiness Resources appears to be a healthcare organization providing remote clinical services focused on medical readiness and health assessments, supporting military and government health programs.

Are you a compassionate and reliable healthcare professional looking to make a meaningful impact? We are seeking licensed Nurse Practitioners (NP/APNP) holding an active U.S. Virgin Islands license to conduct remote health assessments for U.S. military service members. This fully remote position offers total scheduling flexibility, allowing you to choose your own hours while supporting the health, safety, and mission readiness of those who serve. Key Responsibilities: • Conduct telehealth medical evaluations, including Periodic Health Assessments (PHA) and Post-Deployment Health Reassessments (PDHRA). • Review patient medical histories to evaluate overall health and deployment readiness. • Provide clear patient education and communicate medical findings professionally. • Refer complex cases to physicians or Military Treatment Facilities (MTFs) when advanced care is necessary. • Complete accurate, timely, and concise electronic medical documentation for all assessments. • Maintain strict HIPAA compliance, follow SC PHA guidelines, and participate in routine quality audits. Strict Qualifications & Requirements: • Licensure: Active, unrestricted NP/APNP license in the U.S. Virgin Islands (VI). • Insurance: Current, active malpractice insurance meeting or exceeding contract requirements. • Supervision: An active collaborative agreement or supervising physician (MD) already established, as required by local regulations. • Training: Completion of required HIPAA and SC PHA training (available as initial and refresher courses through JKO). • Excellent communication skills and a strong commitment to high-quality patient care. Why Join Us: • 100% Remote: Enjoy the freedom of working completely from home. • Flexible Schedule: Set a workday routine that fits your lifestyle. • Mission-Driven: Directly contribute to the health and readiness of U.S. military personnel. Job Types: Part-time, Contract Pay: $30.00 - $90.00 per hour Benefits: • Flexible schedule Experience: • Nurse Practitioner: 1 year (Required) License/Certification: • Virgin Islands (Required) • Malpractice Insurance (Required) • Supervising Physician (Preferred) Work Location: Remote

CVS Health

Case Manager Registered Nurse - Work At Home - San Antonio Texas

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Case Management Nurse

License:

RN

State License:

Compact / Multi-State

CVS Health is an integrated healthcare company operating retail pharmacies, pharmacy benefit management, health services, and clinical programs, providing in-person and virtual care solutions nationwide.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Remote Case Manager RN – Costco Team (San Antonio, TX) 100% Remote | Full-Time | Weekday Schedule Join our dedicated Costco Team as a Remote Case Manager RN and make a meaningful impact on members’ health and wellness from the comfort of your home. What You’ll Do As a Case Manager RN, you’ll play a vital role in improving health outcomes by: • Assessing member needs and developing personalized care plans • Coordinating care and connecting members with appropriate resources • Identifying risks and removing barriers to better health • Collaborating with multidisciplinary teams to drive positive outcomes • Supporting members through telephonic and occasional virtual interactions What We’re Looking For - REQUIRED • Active, unrestricted multi-state RN license in the state of residence • 3+ years of clinical RN experience • Comfort using multiple systems (Microsoft Office and other tools) • Ability to work Monday–Friday, 8 AM–5 PM CST (with occasional 10 AM–7 PM rotation) • Willingness to obtain additional state licenses (covered by employer) • Associate degree in nursing Nice to Have • Preference for those living within 45 minutes of San Antonio, TX • Integrated case management experience • Bilingual (Spanish/English) • BSN Why Join Us? • Fully remote flexibility • Meaningful, patient-focused work • Supportive team environment • Opportunity to expand licensure at no cost Apply today to help drive healthier outcomes for members nationwide Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 06/06/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Health Readiness Resources

Telehealth Nurse Practitioner/ PA (Mississippi Licensed)-Military Health Assessments

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Triage

License:

NP

State License:

Mississippi

Health Readiness Resources: a healthcare organization providing remote medical and readiness assessment services, supporting telehealth assessments for military personnel.

Are you a dedicated healthcare professional looking to support the health and readiness of U.S. Military service members? We are seeking experienced, Mississippi-licensed Nurse Practitioners (NP/APNP)/ PA to conduct remote health assessments via phone and video. This fully remote role offers flexible scheduling, allowing you to set your own hours while making a meaningful impact on military mission readiness. Key Responsibilities: • Perform telehealth assessments, including PHAs, PDHRAs, and related medical evaluations. • Assess medical conditions, determine deployment eligibility, and make appropriate referrals. • Provide clear patient education, explaining all findings and procedures to service members. • Complete accurate, thorough, and timely medical documentation. • Participate in internal quality audits and maintain compliance with HIPAA and SC PHA standards. Strict Qualifications & Requirements: • Licensure: Must hold an active, unrestricted Mississippi NP/APNP license. • Insurance: Must carry active malpractice insurance that meets Mississippi or contract guidelines. • Supervision: Must have an established collaborating/supervising physician (this is not provided by the company). • Training: Completion of HIPAA and SC PHA training through JKO (initial and ongoing). • Strong communication skills and a commitment to high-quality clinical care. What We Offer: • 100% Remote / Work from Home. • Flexible Scheduling – Choose hours that fit your lifestyle. • Mission-Driven Impact – Directly support the readiness of U.S. service members. Job Types: Part-time, Contract Pay: $40.00 - $80.00 per hour Benefits: • Flexible schedule Application Question(s): • Does have Supervising MD Experience: • Nurse Practitioner: 1 year (Required) License/Certification: • Mississippi License (Required) • Malpractice/Liability Insurance (Required) Work Location: Remote

The Cigna Group

(RN) Nurse Case Manager - Evernorth Health Services -Remote

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Case Management Nurse

License:

RN

State License:

Not Specified

The Cigna Group is a global health services company; Evernorth is Cigna’s health services subsidiary offering care management, pharmacy, and behavioral health solutions to improve member outcomes.

The job profile for this position is Nurse Case Management Lead Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Position Scope Hours for the position: Must be able to work an 8-hour-shift between the business hours of 9a-9p EST. Flexibility is required to meet business needs. Must be open to work evenings. Role Summary: The Nurse Case Manager serves as a customer advocate, partnering with members, families, and providers to coordinate care and support navigation of the healthcare system. This role focuses on whole-person health, behavior change, and delivering high-quality, customer-centered outcomes aligned with Care Solutions cultural beliefs. Key Responsibilities: • Partner with customers to develop, implement, and document individualized care plans. • Use motivational interviewing, behavior change strategies, and shared decision-making to support health goals. • Coordinate care with providers, caregivers, and internal clinical partners to support whole-person health. • Engage customers through telephonic, digital, and written communication channels. • Track and document activities, outcomes, and progress in medical management systems. • Follow standard operating procedures and meet defined case management performance measures. • Maintain clinical expertise through required training and continuing education. Required Qualifications: • Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory. • Minimum of two (2) years of full-time direct patient care experience as an RN. • Nursing degree from an accredited nursing program. • Ability to work an 8-hour shift between 9:00 a.m. and 9:00 p.m. EST, including evenings as business needs require. • Strong communication skills across telephonic and digital platforms. • Proficiency with Microsoft Word, Excel, Outlook, and clinical documentation systems. Preferred Qualifications: • Case management certification (URAC-recognized) obtained within four (4) years of hire. • Experience working in remote, telephonic, or digital care management environments. • Strong organizational skills with the ability to manage multiple priorities in a fast-paced setting. • Demonstrated ability to work effectively with culturally diverse populations. • Flexibility to support non-standard shifts or occasional on-site meetings or audits If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 77,500 - 129,100 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

LifeChef Health & OnPoint Nutrition

Remote Telehealth Registered Nurse (RN) – Chronic Care, RPM & Care Coordination

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Care manager

License:

Compact RN

State License:

Compact / Multi-State

LifeChef Health & OnPoint Nutrition: a healthcare organization offering chronic care services combining nutrition, medically tailored meals, remote patient monitoring, and virtual clinical support to manage diabetes, heart disease, obesity, and metabolic health.

Position Overview LifeChef Health is building a next-generation chronic care platform combining Registered Dietitians, medically tailored meals, remote patient monitoring, and personalized clinical support to improve outcomes for patients with diabetes, heart disease, obesity, and other chronic conditions. We are seeking a compassionate, tech-savvy Remote Telehealth RN to support patients with chronic conditions through virtual engagement, remote patient monitoring (RPM), and interdisciplinary care coordination. This role focuses on helping patients improve adherence, stay connected to care, and achieve better health outcomes through proactive outreach and personalized support. This role is ideal for nurses who enjoy building long-term patient relationships and proactively helping patients improve their health outcomes. Key Responsibilities Remote Patient Monitoring (RPM): ● Monitor daily/weekly biometric data (e.g., blood pressure, glucose, weight) ● Identify trends, abnormalities, and gaps in care ● Escalate clinical concerns to providers as appropriate ● Document and track patient data in the EMR/RPM platform Care Coordination: ● Serve as a primary point of contact for assigned patients ● Coordinate care between providers, specialists, and ancillary services ● Support medication adherence and care plan compliance ● Assist with transitions of care (e.g., post-discharge follow-up) Patient Engagement & Coaching: ● Conduct regular virtual check-ins (phone/video) ● Provide education on chronic disease management and lifestyle changes ● Support patients enrolled in the LifeChef program (nutrition, weight, metabolic health) ● Encourage adherence to personalized care plans Documentation & Compliance: ● Maintain accurate, timely documentation in accordance with RPM/CCM billing requirements ● Ensure compliance with HIPAA and all regulatory standards ● Track time and activities to support reimbursement workflows Qualifications ● Active, unrestricted RN license — must reside in a Nurse Licensure Compact (NLC) state and hold or be eligible for a multistate RN license ● Minimum 3+ years clinical experience (primary care, chronic care, or care management preferred) ● Experience with RPM, CCM, or care coordination programs strongly preferred ● Experience with telehealth, chronic care management, remote patient monitoring (RPM), or care coordination strongly preferred ● Comfortable engaging patients by phone, SMS, and virtual platforms ● Strong communication and patient engagement skills ● Bilingual Spanish/English preferred ● Comfortable using EMRs and digital health platforms ● Highly organized, proactive, and able to work independently ● Interest in lifestyle medicine, nutrition, or metabolic health is a plus Work Environment ● 100% remote position ● Flexible scheduling with defined patient touchpoints ● Collaborative, team-based environment with physicians, APPs, and health coaches Why This Role is Unique ● Focus on proactive, relationship-based care, not task-based nursing ● Opportunity to work at the intersection of clinical care, lifestyle medicine, and technology ● Be part of LifeChef Health’s innovative care model that is redefining how we manage chronic disease Pay: $75,000.00 - $95,000.00 per year Benefits: • Dental insurance • Health insurance • Paid time off Work Location: Remote

Prisma Health

Registered Nurse (RN)- Population Health, Remote, Full-Time, Days

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Population Health

License:

Compact RN

State License:

Compact / Multi-State

Prisma Health is a not-for-profit healthcare organization based in South Carolina that operates hospitals, clinics, and community health services across the state.

Inspire health. Serve with compassion. Be the difference. Job Summary Responsibility for initiating phone contact with discharged patients from specified units, conducting query on patient experience and recovery, and providing needed follow up to patients and/or family members. Coordinates patient responses requiring further intervention with appropriate Nurse Manager. Works independently and/or under indirect supervision of the Nurse Manager. Remote position for SC Residents Essential Functions • All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. • Conduct non–face-to-face post-discharge outreach calls to patients within the CMS-required timeframe. • Review discharge summaries, medication lists, and follow-up instructions prior to patient contact. • Medication reconciliation and coordination support. • Assess patient understanding of discharge plan, symptom management, and medication adherence. • Records patient responses and advice provided, documents any variations. Provides appropriate follow up as indicated by patient responses and needs. • Identify early signs of potential complications and escalate concerns to the provider or care team. • Schedule appointments directly with the patient’s primary care provider. • Coordinate with front desk and clinical teams to secure timely appointment availability. • Document all outreach attempts, patient interactions, and outcomes in the EHR according to Prisma Health and CMS requirements. • Provide/Reinforce education provided at discharge, including when to contact the provider versus seek emergency care. • Support readmission prevention efforts by ensuring appropriate follow-up and addressing barriers to care. • Review and address open care gaps (e.g., hypertension control, diabetes monitoring, preventive screenings, wellness visits). • Educate patients on the importance of completing overdue screenings or visits and assist in scheduling. • Collaborate with providers, care coordinators, and case management teams to ensure continuity of care. • Participate in team discussions and quality improvement initiatives related to department effectiveness and patient outcomes. • Maintain awareness of required documentation and billing requirements to ensure compliance. • Provide hypertension-focused education on home blood pressure monitoring, medication adherence, lifestyle modifications, and follow-up importance. • Assess and intervene for elevated blood pressure readings or medication concerns by escalating to the provider and facilitating appropriate follow-up. • Collects patient data and completes required forms with appropriate responses according to the unit standards; identifies patient's problems/needs and sets priorities; identifies problems requiring further referral and/or follow-up; observes and records latest diagnostic results; performs advanced nursing observations using critical thinking skills. • Develops a plan for follow up care based on nursing process, and which incorporate the plans of other disciplines and continuing or emerging care needs; include the patient/family in developing or revising plan. • Care provided conforms to accepted practice standards; provides correct telephonic care advice and other follow up instructions according to patient care standards; demonstrates understanding of age-related characteristics and needs of patients served; explains nursing procedures and discharge teaching in appropriate forms; evaluates care measures instituted; identifies situations that require immediate action and provides appropriate plan; understands and demonstrates respect for patient rights and confidentiality, and identifies mechanism for management of any ethical issues. • Performs other duties as assigned. Supervisory/Management Responsibilities • This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements • Education - Associate degree in Nursing. Bachelor's degree in Nursing preferred. • Experience - One (1) year experience as a registered nurse. In Lieu Of • In lieu of an associate’s degree in nursing (AD N), will accept an RN diploma or certificate with a current RN compact/multistate license recognized by the NCSBN Compact State or a license to practice as an RN in the state the team member is working. Required Certifications, Registrations, Licenses • Holds a current RN compact/multistate license recognized by the NCSBN Compact State or is licensed to practice as an RN in the state the team member is working. Knowledge, Skills and Abilities • N/A Work Shift Location Blount Memorial Hospital Facility 7002 Value-Based Care and Network Services Department 70029261 Ambulatory Quality and Reliability Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

Broadway Ventures

Remote Home Health RN – Medical Claims Reviewer

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Utilization Review

License:

Compact RN

State License:

Compact / Multi-State

Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business delivering program management, technology, and consulting services to government and private-sector clients.

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider—we're your trusted partner in innovation. Job Type: Full-time (40 hours/week) Schedule: Monday–Friday, 8:00 AM – 5:00 PM Max Salary: W-2 ($60,000-$63,000) Location: Remote (U.S. – Work from home) Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed. About the Role We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements. Key Responsibilities • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals. • Assess payment determinations using clinical information and established guidelines. • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement. • Provide clear, well-documented rationales for service approvals or denials. • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements. • Support quality control activities to meet corporate and team objectives. • Provide guidance to LPN team members and support non-clinical staff through training and discussions. • Assist with special projects and additional responsibilities as assigned. Minimum Qualifications Licensure: • Active, unrestricted RN license in the U.S. and in the state of hire OR • Active compact multistate RN license (as defined by the Nurse Licensure Compact). Education: • Associate Degree in Nursing OR • Graduate of an accredited School of Nursing. Experience: • Two years of clinical experience plus at least two years in one of the following: • Home Health • Utilization/Medical Review • Quality Assurance Skills & Competencies: • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings. • Ability to interpret and apply medical review criteria and clinical guidelines. • Proficiency in Microsoft Office and word processing software. • Strong analytical, organizational, and decision-making skills. • Ability to work independently while managing priorities effectively. • Excellent customer service, communication, and critical thinking skills. • Ability to handle confidential information with discretion. Preferred Qualifications • Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred). • Proficiency in using multiple screens and software programs simultaneously. If you are a detail-oriented RN with a passion for medical review, we encourage you to apply! What to Expect Next: After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting. Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law. Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).

Med Surg Hospitalization Expert

Remote/Hybrid Registered Nurse (RN) – Advocacy & Program Integrity (Medical Assistance- Med Surg Hospitalization Expert)

Posted on:

May 21, 2026

Job Type:

Active

Role Type:

Utilization review nurse

License:

State-Specific RN

State License:

Pennsylvania

A Pennsylvania-based quality improvement organization focused on healthcare program integrity, advocacy, and improving care for vulnerable populations; hires nurses for remote utilization review and quality roles.

Are you a registered nurse ready to take your career in an exciting new direction—one where your expertise truly makes a difference? Join Pennsylvania’s premier Quality Improvement Organization and step into a dynamic role focused on advocacy and program integrity through compliance management. Here, you’ll champion the needs of vulnerable populations, safeguard the quality of care, and influence healthcare outcomes on a meaningful scale. Enjoy the freedom of working from home, the flexibility and autonomy to manage your workday, and the opportunity for continuous professional growth—all while being part of a passionate, mission-driven team dedicated to improving healthcare across the Commonwealth. Are you a registered nurse ready to take your career in an exciting new direction—one where your expertise creates real, lasting impact? Join Pennsylvania’s premier Quality Improvement Organization and play a vital role in protecting healthcare quality, advocating for vulnerable populations, and ensuring the integrity of critical healthcare programs. In this rewarding role, you’ll use your clinical knowledge outside of the traditional bedside setting to review and audit claims, support program integrity initiatives, and advocate for beneficiaries across the Commonwealth. You’ll enjoy the flexibility of working from home, the autonomy to manage your work, and meaningful opportunities for professional growth—all while contributing to a mission that truly matters. • What You’ll Do • Conduct clinical reviews and ensure quality, appropriateness, and compliance with healthcare standards • Support program integrity efforts by identifying trends, risks, and opportunities for improvement • Advocate for beneficiaries, with a strong focus on protecting and improving care for vulnerable populations • Apply nursing judgment to analyze medical records, documentation, and billing data • Collaborate with interdisciplinary teams, providers, and stakeholders to promote best practices • Contribute to quality improvement initiatives that strengthen healthcare delivery across Pennsylvania • What We’re Looking For • Active, unrestricted Registered Nurse (RN) license • Strong clinical background with the ability to apply nursing judgment analytically • Interest in advocacy, quality improvement, and healthcare program integrity • Excellent written and verbal communication skills • Ability to work independently while managing multiple priorities • Comfort with technology and electronic medical records Experience in utilization review, case management, quality improvement, compliance, or claims review is a plus—but not required. • Why Join Us • Mission-driven work with Pennsylvania’s leading Quality Improvement Organization • Make a real impact on healthcare quality and outcomes for vulnerable populations • Remote work – enjoy the convenience and balance of working from home • Autonomy and flexibility in how you manage your workday • Advocacy-focused role that values your nursing voice and expertise • Career development opportunities to grow beyond traditional nursing roles • Supportive, collaborative team culture committed to excellence and integrity If you’re a registered nurse seeking purpose-driven work, professional growth, and the flexibility to balance your life and career—this is your opportunity. Apply today and help shape the future of healthcare quality in Pennsylvania. • Requirements • Be available as a full-time consultant, approximately 37.5 hours per week; •  Possess a current license to practice as a Registered Nurse issued by the Pennsylvania • State Board of Nursing; or possess a non-renewable temporary practice permit issued • by the Pennsylvania State Board of Nursing. Resources possessing non-renewable • temporary practice permits must obtain licensing as a Registered Nurse within the • one-year period as defined by the Pennsylvania State Board of Nursing; •  Possess a documented work history of three (3) or more years of professional • experience with medical assistance, health care services or human services or any • equivalent combination of experience and training; •  Possess basic computer skills, including familiarity with Microsoft Office programs. • Principal Duties and Responsibilities (RN – Medical Assistance Inpatient Utilization Review & Discharge Planning) • Conduct clinical utilization reviews for medical–surgical inpatient hospitalizations under the Medical Assistance (MA) Program by evaluating medical records, admission criteria, continued stay indicators, and treatment plans to determine medical necessity, appropriateness, and level of care. • Apply registered nursing clinical judgment and evidence-based medical–surgi

HealthEdge

A&G RN (Temporary)

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Utilization Review

License:

RN

State License:

Massachusetts

HealthEdge is on a mission to drive a digital transformation in healthcare. We’re connecting health plans, providers, and patients with end-to-end digital technology solutions to support new business models, reduce administrative costs and improve health outcomes. Our growing portfolio of products (HealthRules® Payer, HealthEdge Source™, HealthEdge® Provider Data Management, GuidingCare®, and Wellframe™) provides talented and passionate professionals with opportunities to lead change and make a lasting, global impact in healthcare. Driving our mission are 2,000+ professionals worldwide. Together, we are committed to innovating a world where healthcare can focus on people.

In this role you should independently be able to effectively and efficiently process the transactions assigned in a timely manner, clarify complex transactions to others and ensure that quality of output and accuracy of information is maintained, in alignment with SLAs. Geographic Responsibility: Remote, US Type of Employment: Full-time, permanent FLSA Classification (USA Only): Exempt

EDUCATION: Bachelor’s degree in nursing, allied health, business, or related field preferred. Registered Nurse with current unrestricted Registered Nurse license required. Certification in Case Management may be preferred based upon designated department assignment. EXPERIENCE: Minimum two (2) years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc. Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes. One (1) year health insurance plan experience or managed care environment preferred. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: Unrestricted USRN mainland license At least 2 years experience in utilization management / review Demonstrated clinical knowledge and experience relative to patient care and healthcare delivery processes. Medicare Advantage experience an advantage Excellent written and verbal communication skills. Excellent customer service and interpersonal skills. Working knowledge of current industry Microsoft Office Suite PC applications. Ability to apply clinical criteria/guidelines for medical necessity, setting/level of care, and concurrent patient management Knowledge of current standard medical procedures/practices and their application as well as current trends and developments in medicine and nursing, alternative care settings, and levels of service Knowledge of applicable accreditation standards, and local, state, and federal regulations Appeals and grievance experience required. Strong problem-solving skills, facilitation skills, and analytical skills. Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:  The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus. Work across multiple time zones in a hybrid or remote work environment. Long periods of time sitting and/or standing in front of a computer using video technology. May require travel dependent on company needs.

Investigate and process complex grievances and appeals requests from members and providers Perform reviews of inpatient, outpatient, ambulatory and ancillary services for medical necessity Review, research, and prepare documentation related to appeals and grievances in accordance with local, state, and federal regulatory and designated accreditation (e.g., NCQA) standards Prepare recommendations to either uphold or deny appeal and work with the Medical Director for further review Document and logs appeal/grievance information on relevant tracking systems Generate written correspondence to providers, members, and regulatory entities Serve as a subject matter expert for appeals, grievances, and quality of care issues Utilize leadership skills Assist with or perform other relevant essential functions as required This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

Prolific

AI Trainer - Registered Nurse

Posted on:

May 20, 2026

Job Type:

Temporary

Role Type:

Not Nursing

License:

RN

State License:

California

Prolific is not just another player in the AI space – we are building the biggest pool of quality human data in the world. Over 35,000 AI developers, researchers, and organizations use Prolific to gather data from paid study participants with a wide variety of experiences, knowledge, and skills.

We’re looking for Registered Nurses to help train and evaluate cutting-edge AI models. If you have the necessary experience, we’ll send you a quick test to assess your skills and suitability for AI tasks. If successful, you’ll be invited to join Prolific as a Domain Expert participant, where you’ll get paid to train and evaluate powerful AI models. Researchers looking for your skills tend to pay $80-$150p/h per AI task completed. You must be prepared to complete paid tasks that require one hour of uninterrupted work, though many are shorter.

Verified status as a registered nurse (e.g., current license/registration in good standing; board certification or equivalent where applicable) Recent clinical experience and comfort evaluating clinical reasoning and decision-making Willingness to complete a short skills/eligibility screener to join our Domain Expert pool Strong attention to detail and the ability to focus on complex tasks for up to one hour A reliable, fast internet connection and access to a computer Willingness to self-declare earnings (participants are self-employed) A PayPal account to receive payments from our clients

Reviewing AI-generated responses to clinical scenarios and rating them for accuracy, clinical appropriateness, safety, and reasoning quality Comparing multiple model answers and selecting/justifying the best response Writing improved exemplars, rationales, or structured feedback to help models learn where they fall short

Call 4 Health

Remote RN Telephone Triage Nurse – Compact License + IL, MA, NY, MN, DC Required

Posted on:

May 20, 2026

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Call 4 Health is a leading medical call center and nurse triage service with a genuine understanding of the patient’s perspective. Delivering compassionate commitment with quality medical solutions to our clients since 1997, Call 4 Health has a keen understanding of what it is like to face trauma and has developed a sound system to seamlessly balance professionalism with compassion. Our altruistic approach places patients and their families first by using state-of- the-art technology and compassionate training initiatives. Call 4 Health is always ready with real solutions consistent with the needs of both the client and the patient.

We are seeking experienced Registered Nurses with an active Compact State RN License plus multiple state licenses. Candidates with active IL, MA, NY, MN, and DC licenses are highly preferred. Additional active licenses in CA, NV, OR, AK, CT, and MI are required. Applicants must have open availability and flexibility to work days, nights, weekends, and rotating schedules based on business needs. Job Summary: The Registered Nurse (RN) will play a crucial role as a physician extender within the healthcare team, operating in a remote capacity. In this role, the RN will support providers by efficiently managing Electronic Health Records (EHR), addressing patient inquiries, and delivering clinical guidance to ensure optimal patient care. This position involves responding to calls for a multi-state nurse triage telephone service, managing inbound and outbound patient calls, triaging patient needs, conducting follow-ups, and facilitating effective communication among healthcare professionals and patients, ultimately enhancing patient outcomes and team effectiveness.

Education and/or Experience: Bachelor’s or Associate’s Degree in Nursing. Minimum of 2-4 years of full-time clinical experience as a Registered Nurse, preferably in areas such as ER/Urgent Care, Adult, Pediatric, OB/GYN, Orthopedic, Ambulatory Care, Home Health, or ICU. Previous telephone triage experience using electronic triage systems and at least two Bachelor’s or Associate’s Degree in Nursing. Minimum of 2-4 years of full-time clinical experience as a Registered Nurse, preferably in areas such as ER/Urgent Care, Adult, Pediatric, OB/GYN, Orthopedic, Ambulatory Care, Home Health, or ICU. Previous telephone triage experience using electronic triage systems and at least two Qualifications & Skills: We are committed to providing our employees with the support they need. At Call 4 Health, we offer eligible employees an attractive benefit package that includes medical, wellbeing, dental and vision benefits along with some unique benefits including: Teamwork: Demonstrated ability to collaborate effectively with peers, cross-functional teams, and leadership. Leadership: Proactive in stepping up to lead, when necessary, capable of motivating colleagues, and sharing knowledge for the enhancement of team performance. Customer Service: Exceptional empathy, patience, and active listening skills to understand and address patient needs effectively. Quality: Strong attention to detail in charting, utilizing correct grammar, spelling, and medical terminology to ensure complete and accurate patient documentation. Organization and Time Management: Highly organized, capable of handling and documenting at least four calls per hour during peak times Physical Requirements: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee must be able to sit for extended periods, talk, and engage in active listening without visual contact with patients. Occasional standing and the use of hands for operating office equipment are required, with infrequent stooping, kneeling, or crouching. Ability to hear in normal range and wear a headset/ earpiece Good visual acuity to read computer screens, scripts, forms etc. Able to work remotely at home in a private HIPAA compliant workspace Able to house company equipment needed to perform job Broadband Internet Access Participation (via telephone or video) in staff meetings Work Environment Able to thrive in a fast-paced environment. Demonstrated capability to maintain professional relationships with diverse personalities. Must be flexible and adaptable to change, managing stress effectively. May require occasional overtime or adjusted start times.

The following duties and responsibilities reflect the expectations of this position but are not all-inclusive. Track and respond to calls for a multi-state nurse triage telephone service, receiving inbound calls from patients and placing outbound calls, while utilizing Schmitt-Thompson telephone triage protocols to document patient interactions effectively within clients’ EHR and/or a Call 4 Health platform. Provide clinical assessment based on established protocols and triage patients by phone or through patient portal. Provide administrative support and perform clinical tasks such as medication prescription refills per established protocols, notifying providers of critical results, and coordinating follow-up care post-discharge or post-operative. Facilitate referrals and collaborate on addressing prior authorization requests that require clinical consultation, while also assisting with requests from other agencies such as hospitals, nursing homes, funeral homes, and Departments of Labor or Motor Vehicles. Participate in Remote Patient Monitoring (RPM) initiatives by tracking patients' vital signs and delivering education on managing chronic diseases such as diabetes, hypertension, and COPD. Screen and qualify patients for clinical trials. Perform follow-ups and patient education. Carry out additional responsibilities as needed to assist the healthcare team and enhance the delivery of patient care.

Call 4 Health

Nurse Manager w/ AWS & WFM Calabrio Experience - Remote (RN Compact License Required)

Posted on:

May 20, 2026

Job Type:

Full-Time

Role Type:

Leadership

License:

RN

State License:

Compact / Multi-State

Call 4 Health is a leading medical call center and nurse triage service with a genuine understanding of the patient’s perspective. Delivering compassionate commitment with quality medical solutions to our clients since 1997, Call 4 Health has a keen understanding of what it is like to face trauma and has developed a sound system to seamlessly balance professionalism with compassion. Our altruistic approach places patients and their families first by using state-of- the-art technology and compassionate training initiatives. Call 4 Health is always ready with real solutions consistent with the needs of both the client and the patient.

The Nurse Manager at Call 4 Health provides clinical and operational leadership for a high-volume, fully remote Nurse Triage call center. This role is accountable for driving workforce efficiency, schedule adherence, service-level performance, and clinical quality while leading and developing a distributed team of Registered Nurses. The ideal candidate brings deep experience partnering with Workforce Management (WFM), leveraging Calabrio for forecasting, scheduling, real-time monitoring, and performance analysis, and balancing clinical excellence with operational metrics in a telehealth environment. This position works closely with internal stakeholders and client partners to ensure seamless, compliant, and patient-centered service delivery.

Education & Experience Education: BSN required; MSN or MHA preferred Licensure: Active, unrestricted RN license (Compact required) Experience: Minimum 5 years of nurse triage experience At least 2–3 years in a Nurse Manager or call center leadership role Demonstrated experience working with Workforce Management teams and Calabrio in a contact center or telehealth environment Required Qualifications Calabrio Experience: Hands-on experience using Calabrio for forecasting, scheduling, real-time monitoring, adherence tracking, and performance reporting. Workforce Management Partnership: Proven success collaborating with WFM to optimize staffing, reduce shrink, and maintain service levels. AWS Experience Call Center Leadership: Experience leading clinical teams in a high-volume, metrics-driven environment. Data-Driven Decision Making: Ability to translate workforce and QA data into actionable coaching and operational improvements. Remote Leadership: Strong ability to manage, motivate, and hold teams accountable in a fully remote setting. Nice-to-Have Experience supporting 24/7 or after-hours triage operations Multi-client or multi-state telehealth program leadership Advanced QA calibration or clinical coaching program ownership

Workforce Management & Call Center Operations: Partner closely with Workforce Management (WFM) to manage forecasting, scheduling, coverage planning, shrink, and real-time staffing adjustments using Calabrio. Monitor and analyze service-level performance, queue activity, occupancy, adherence, and productivity to ensure SLAs and KPIs are consistently met. Use Calabrio dashboards and reports to identify trends, risks, and opportunities; proactively implement corrective actions. Lead real-time operational decision-making in collaboration with WFM to address call volume fluctuations, absenteeism, and intraday staffing challenges. Ensure operational workflows support safe, efficient nurse triage while maintaining regulatory and client requirements. Staff Leadership & Performance Management: Lead, coach, and develop approximately 30 RN direct reports in a remote call center environment. Drive accountability for schedule adherence, attendance, productivity, and quality metrics. Conduct performance evaluations informed by Calabrio data, QA findings, and operational reports. Partner with QA and Training to implement targeted coaching plans based on performance and trend analysis. Foster a culture of ownership, transparency, and continuous improvement. Clinical Quality & Patient Safety: Ensure adherence to triage protocols, escalation pathways, and clinical documentation standards. Support QA calibration, call monitoring, and chart audits to maintain clinical excellence and compliance. Address escalations and patient concerns promptly while maintaining professional and compassionate communication. Ensure compliance with HIPAA and all applicable state and federal regulations. Collaboration & Reporting: Act as a key liaison between Operations, Workforce Management, QA, IT, Training, and client stakeholders. Prepare and present operational and workforce performance reports, including adherence, SLA attainment, staffing efficiency, and quality outcomes. Participate in strategic planning, workflow optimization, and operational improvement initiatives.

Call 4 Health

Weekend Remote RN Opportunity | Compact License + CA, IL, MA, NV, NY, MN, OR, DC

Posted on:

May 20, 2026

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Call 4 Health is a leading medical call center and nurse triage service with a genuine understanding of the patient’s perspective. Delivering compassionate commitment with quality medical solutions to our clients since 1997, Call 4 Health has a keen understanding of what it is like to face trauma and has developed a sound system to seamlessly balance professionalism with compassion. Our altruistic approach places patients and their families first by using state-of- the-art technology and compassionate training initiatives. Call 4 Health is always ready with real solutions consistent with the needs of both the client and the patient.

The Registered Nurse (RN) plays a critical role as a physician extender within a remote healthcare team. In this position, the RN supports providers by efficiently managing Electronic Health Records (EHR), responding to patient inquiries, and delivering timely clinical guidance to promote high-quality patient care. This role includes responding to calls for a multi-state nurse triage telephone service, managing inbound and outbound patient communications, assessing and triaging patient needs, conducting follow-up outreach, and facilitating effective communication between patients and healthcare professionals. The RN contributes directly to improved patient outcomes and overall team effectiveness.

Education and Experience: Associate’s or Bachelor’s Degree in Nursing. Minimum of 2–4 years of full-time clinical experience as a Registered Nurse, preferably in areas such as Emergency Room/Urgent Care, Adult or Pediatric Care, OB/GYN, Orthopedics, Ambulatory Care, Home Health, or ICU. Prior telephone triage experience using electronic triage systems and experience with at least two different Electronic Health Record (EHR) platforms. Active, unencumbered Enhanced Nurse Licensure Compact (eNLC) license required. Additional non-compact state licensure is considered an asset. Candidates must be willing to obtain additional state licenses as requested by the company. Qualifications and Skills Teamwork: Proven ability to collaborate effectively with peers, cross-functional teams, and leadership. Leadership: Willingness to step into leadership when needed, motivate colleagues, and share knowledge to enhance team performance. Customer Service: Strong empathy, patience, and active listening skills to effectively address patient needs. Quality and Accuracy: Excellent attention to detail in documentation, including correct grammar, spelling, and medical terminology. Organization and Time Management: Highly organized, with the ability to manage and accurately document a minimum of four calls per hour during peak times. Physical Requirements: The physical demands described below are representative of those required to successfully perform the essential functions of this role. Reasonable accommodations may be made for individuals with disabilities. Ability to sit for extended periods while speaking and actively listening without visual contact with patients. Occasional standing and use of hands for operating office equipment; infrequent stooping, kneeling, or crouching. Ability to hear within normal range and comfortably wear a headset or earpiece. Adequate visual acuity to read computer screens, scripts, and forms. Ability to work remotely from a private, HIPAA-compliant home workspace. Ability to house company-provided equipment necessary for job performance. Reliable broadband internet access. Ability to participate in staff meetings via telephone or video. Work Environment: Ability to thrive in a fast-paced, remote environment. Demonstrated capability to maintain professional relationships with diverse personalities. Flexibility and adaptability to change, with effective stress-management skills. May require occasional overtime or adjusted start times based on operational needs.

The duties and responsibilities outlined below represent the general expectations of the role but are not all-inclusive. Track and respond to calls for a multi-state nurse triage telephone service, including receiving inbound patient calls and placing outbound calls, while utilizing Schmitt-Thompson telephone triage protocols to accurately document patient interactions within client EHR systems and/or the Call 4 Health platform. Provide clinical assessments based on established protocols and triage patients via telephone or patient portals. Perform administrative and clinical support tasks, including medication prescription refills per established protocols, notifying providers of critical results, and coordinating follow-up care after hospital discharge or surgical procedures. Facilitate referrals and collaborate on prior authorization requests requiring clinical consultation. Assist with inquiries from external agencies such as hospitals, nursing homes, funeral homes, and Departments of Labor or Motor Vehicles. Participate in Remote Patient Monitoring (RPM) programs by reviewing patient vital signs and providing education related to chronic disease management, including diabetes, hypertension, and COPD. Screen and qualify patients for clinical trials, conduct follow-up outreach, and provide patient education as required. Perform additional duties as assigned to support the healthcare team and enhance patient care delivery.

Call 4 Health

Licensed Practical Nurse (LPN) – Full-Time, Call Center Remote | Compact License Required

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Primary Care

License:

LPN/LVN

State License:

Compact / Multi-State

Call 4 Health is a leading medical call center and nurse triage service with a genuine understanding of the patient’s perspective. Delivering compassionate commitment with quality medical solutions to our clients since 1997, Call 4 Health has a keen understanding of what it is like to face trauma and has developed a sound system to seamlessly balance professionalism with compassion. Our altruistic approach places patients and their families first by using state-of- the-art technology and compassionate training initiatives. Call 4 Health is always ready with real solutions consistent with the needs of both the client and the patient.

The Licensed Practical Nurse (LPN) will play a crucial role within the Call4Health care team, operating in a remote capacity. In this role, LPN will support Call4Health clients by efficiently managing Electronic Health Records (EHR) and patient portals. In addition, the LPN will provide patient education, troubleshoot Remote Patient Monitoring (RPM) equipment and results, counsel patients with chronic diseases, follow up with patients in between provider visits, and refill medications per protocol. The LPN will follow established protocols in order to facilitate effective communication among healthcare professionals and patients, ultimately enhancing patient outcomes and relieving provider stress.

Education and/or Experience Licensed Practical Nurse 5+ years of full-time clinical experience as an LPN, particularly in primary care for adult, pediatric and geriatric patients. Experience in OB/GYN, Orthopedic, Ambulatory Care or Home Health are also Experience using at least two electronic health record (EHR) systems is required An active unencumbered e-NCL or Enhanced Nurse Licensure Compact license, additional non-compact state licensure would be considered an asset; candidates should also be willing to obtain additional licenses at the company’s request. Qualifications & Skills Teamwork: Demonstrated ability to collaborate effectively with peers, cross-functional teams, and client Leadership: Proactive in stepping up to lead, when necessary, capable of motivating colleagues, helping to troubleshoot problems and sharing knowledge for the enhancement of team Customer Service: Exceptional empathy, patience, and active listening skills to understand and address patient needs Quality: Strong attention to detail in charting, utilizing correct grammar, spelling, and medical terminology to ensure complete and accurate patient Organization & Time Management: Highly organized, capable of handling and documenting tasks, delegating to others where possible, and providing thorough communications to providers, patients and staff. Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee must be able to sit for extended periods, talk, and engage in active listening without visual contact with Occasional standing and the use of hands for operating office equipment are required, with infrequent stooping, kneeling, or Ability to hear in normal range and wear a headset/ earpiece Good visual acuity to read computer screens, scripts, forms Able to work remotely at home in a private HIPAA compliant workspace Able to house company equipment needed to perform job Broadband Internet Access Participation (via telephone or video) in staff meetings Able to thrive in a fast-paced Demonstrated capability to maintain professional relationships with diverse Must be flexible and adaptable to change, managing stress May require occasional overtime or adjusted starting Experience Required 2 years: Primary Care Experience 5 years: Full Time Clinical Experience as an LPN

The following duties and responsibilities reflect the expectations of this position but are not all- inclusive. Monitor Physician EHR inboxes and patient portal requests and perform tasks within LPN scope of practice, and respond to patient inquiries according to established protocols. Refill prescription requests by established protocols, notify providers and ensure patient care tasks are completed for critical results, and coordinate follow-up care post-discharge or post-operative. Facilitate referrals and collaborate on addressing prior authorization requests that require clinical consultation, while also assisting with requests from other agencies such as hospitals, Public Health departments, nursing homes, funeral homes, and Departments of Labor or Motor Manage Remote Patient Monitoring (RPM) results by tracking patients' real-time disease results and delivering education on managing chronic diseases such as diabetes, hypertension, and COPD. Medically screen and qualify patients for clinical trials. Perform follow-ups and patient education. Carry out additional responsibilities as needed to assist the healthcare team and enhance the delivery of patient

Onco360 Oncology Pharmacy

Oncology Nurse Navigator

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

Onco360 is a unique Oncology Pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Our Onco360 Pharmacy in Louisville, KY has a need for a Oncology Nurse Navigator to join our growing team! The hours for this position will be 11:30-8 EST M-F. This position is remote but you must live within commutable distance to our pharmacy location in Louisville, KY.

Starting salary of $72K and above The Oncology Nurse Navigator is a nursing professional who specializes in caring for people with cancer. This position will provide professional services to Oncology patients in a manner that maximizes quality and patient safety. This position is responsible for helping to coordinate the many aspects of care throughout the patient’s cancer treatment. They will manage and counsel patients and follow set policies and procedures that are established for Onco360 pharmacies.

Education/Learning Experience Required: Bachelors of Science in Nursing Desired: 1+ years’ experience in oncology Work Experience Required: 1+ years in a healthcare setting Desired: 1+ years in specialty pharmacy setting Skills/Knowledge Required: compassion, good communication skills, critical thinking, adaptability, attention to detail Desired: clinical and/or case management experience Licenses/Certifications Required: Current license as registered nurse Desired: ONCC or ONS certification Behavior Competencies Required: compassionate, outgoing and energetic attitude, multi-tasking ability, good listening skills

Communicate with patients helping them understand the disease, treatment plan and possible side effects. Provides medication therapy management. Assist health care providers and patients, greeting them by phone, answering questions and requests. Review medical and health history of patients. Communicates with patients and physician’s office staff. Complies with professional practice and patient confidentiality laws. Document any adverse drug reactions according to manufacturer guidelines. Informs pharmacy manager of medication errors. Documents all communication with physicians, or other healthcare providers. Follow up with patients and providers to monitor progress towards meeting drug treatment goals.

NPHire

Work From Home NP (Nationwide Telehealth - Flexible Hours – Full Benefits)

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Telehealth

License:

NP/APP

State License:

Compact / Multi-State

NPHire connects top NP talent with leading healthcare employers and staffing agencies. We're the only job-matching platform built exclusively for Nurse Practitioners, simplifying both the job search and the hiring process so the best match rises to the top every time.

A growing nationwide telehealth organization is hiring Nurse Practitioners to provide virtual women’s health and primary care for adult patients across the U.S. This fully remote position offers structured hours, clinical autonomy, and strong professional support, ideal for providers who value balance, flexibility, and purpose-driven care. Whether you’re an experienced NP or looking to expand your telehealth experience, this is an opportunity to make an impact through modern, patient-first care—without leaving home.

Active NP license in at least one U.S. state (multi-state licenses preferred) FNP, WHNP, or ANP certification required Excellent communication and EMR documentation skills Comfortable practicing independently in a telehealth environment

Conduct telehealth visits for women’s health, wellness, and midlife care Manage hormonal and lifestyle-related health needs using evidence-based guidelines Provide education and personalized treatment options for every patient Collaborate with a supportive, nationwide clinical team Participate in continuous training and clinical development

Precision Financials

LPN/RN/NP/RCP Healthcare Financial Professional

Posted on:

May 20, 2026

Job Type:

Full-Time

Role Type:

Not Nursing

License:

RN

State License:

Compact / Multi-State

Precision Financials is committed to fostering financial freedom by equipping individuals with essential financial literacy skills and knowledge. Our mission is to empower professionals to take control of their financial future and achieve their personal and professional goals. We offer educational tools and guidance to cultivate confidence and expertise in financial decision-making. At Precision Financials, we are a team of driven financial professionals dedicated to empowering individuals and families through financial education and leadership. We believe that financial literacy is the cornerstone of true financial independence—and our mission is to equip our clients with the knowledge, tools, and confidence they need to take control of their financial future

This remote role is designed for licensed healthcare professionals such as Registered Nurses (RN), Nurse Practitioners (NP), or Respiratory Care Practitioners (RCP) who are interested in expanding their expertise to include financial literacy and planning. The Financial Professional will work with clients to educate, develop personalized financial plans, and provide insights into financial processes. Work From Home Opportunity — Ideal for Nurses (LPNs, RNs, NPs), and Respiratory Therapists (RCP) Founded by an ER RN | Helping People Beyond the Bedside 100% Remote | Work from Anywhere with Wi-Fi Flexible Schedule | Part-Time or Full-Time High Income Potential | Full Training Provided Are you a Registered Nurse, Nurse Practitioner, or Respiratory Care Practitioner who’s passionate about helping people—but seeking a career that offers more freedom, less burnout, and long-term financial stability? You’re not alone. Many healthcare professionals are discovering a new way to serve others—without sacrificing their own health, time, or family life. This opportunity was founded by a career Emergency Room RN who spent years on the frontlines, and now empowers nurses and other purpose-driven professionals to transition from bedside care to financial care. About the Role: Financial Professional (No Experience Required) As a licensed Financial Professional, you'll educate families, individuals, and small business owners on how to protect and build wealth through services such as: Life Insurance with Living Benefits Retirement Planning (401k rollovers, indexed accounts, annuities) College Savings Plans Business Protection Strategies You’ll receive full training, licensing support, mentorship, and ongoing professional development—even if you have no prior experience in finance or business. Why Nurses and Healthcare Professionals Thrive in This Role Healthcare providers naturally excel in financial services because the skills that make you great in healthcare—empathy, problem-solving, and the ability to educate—are exactly what’s needed here: You’re used to making complex topics understandable You know how to build trust and listen deeply You care about helping others plan for the “what ifs” in life You want work that aligns with your values but fits your life This is a commission-based (1099) opportunity. It’s ideal for nurses, respiratory therapists, and healthcare professionals who are ready to build a meaningful new career—helping others plan, protect, and thrive financially. We're looking for individuals ready to invest in their future and create lasting impact If you’re ready to shift from healthcare to wealthcare—and still change lives—apply today and discover how to help others without the burnout

Basic Qualifications: Able to pass a background check Live in and eligible to work in the United States including Puerto Rico Willing to obtain a state financial license (we support you) Professional, ethical, and strong communication skills Working in a remote setting Accept a background check Authorized to work in the United States

Day-to-day responsibilities include guiding financial decision-making, educating families, and ensuring clients are informed and confident in achieving their financial goals.

Silverado

PRN Remote Hospice Triage Nurse, RN

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Triage

License:

RN

State License:

California

Join Silverado Hospice CA Regional and be part of a nationally recognized team ranked in the top 10 nationwide by Fortune Magazine’s Best Workplaces in Aging Services™. Since 1997, Silverado has been delivering exceptional care to individuals with neurodegenerative conditions and those facing life-limiting illnesses through our Hospice services. We’re a certified Great Place to Work® and proud to offer competitive pay, benefits, and growth opportunities.

We’re hiring a Regional Triage Nurse (RN) – a skilled and compassionate professional who provides telephonic triage, clinical oversight, and coordination of after-hours care across multiple hospice sites. This role is essential to ensuring timely, high-quality care for patients and families during critical moments. Be a Difference-Maker with a Hospice Care Leader You lead with clinical expertise, empathy, and strong communication skills. You thrive in a mission-driven environment and are passionate about supporting patients and families while ensuring smooth coordination of care. Schedule: Monday - Friday 5:00pm - 12:00am, Saturday and Sunday

Active RN licenses in good standing in both California and Texas Minimum of 1 year RN experience, including at least 1 year in end-of-life care Certification as a Hospice and Palliative Nurse (CHPNA) preferred but not required Must clear criminal background check, physical, and drug screening Valid driver’s license, good driving record, and reliable transportation required Willingness to travel to patient locations as needed Ability to work outside regular hours depending on business needs

Oversee and assign on-call/after-hours RN runners for supported hospice sites Provide telephonic assessments and implement appropriate interventions based on patient’s terminal diagnosis and reported symptoms Collaborate with attending physicians, Medical Directors, and interdisciplinary hospice teams Utilize EMR systems (HCHB workflow) as assigned Act as liaison with patients, families, and healthcare professionals while maintaining confidentiality and dignity

Strive Health

Clinical Quality Auditor, Nurse Practitioner

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Quality

License:

NP/APP

State License:

Colorado

At Strive Health, patients come first. We’re on a mission to transform chronic conditions by identifying risk earlier, coordinating thoughtful care, and supporting people through every stage of their health journey. Our work reduces emergency visits, improves outcomes, and helps patients live fuller lives. You’ll work alongside passionate Strivers who care deeply about making an impact, show up for one another as One Team, and find ways to elevate the everyday. If you’re looking for meaningful work where your contributions truly matter, you’ll feel right at home at Strive! Benefits & Perks Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits. Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts. Financial & Retirement Support – Competitive compensation with a performance-based bonus program, 401k with employer match, and financial wellness resources. Time Off & Leave – Paid holidays, vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves. Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend.

As the Clinical Quality Auditor, you will be responsible for completing quality review processes for care management and care delivery programs. This role is responsible for ensuring appropriate clinical and care delivery practices are utilized and case documentation meets established standards consistently to support meeting internal and external quality standards, compliance, and expectations. As an auditor, you will utilize clinical experience, expertise, and quality guidelines to review patient files, care plans and interactions and care plans against appropriate applicable quality criteria in conjunction with program, accreditation and industry requirements. You will support various Kidney Hero roles (clinical and non-clinical) regarding case auditing, outcomes and coaching, quality improvement strategies, resource development and other activities to promote continuous quality improvement. This quality improvement support will be provided to operational managers and leadership to communicate and facilitate resolution for quality risks, such as root cause analysis and remediation recommendations. As a quality auditor, you will serve as a quality liaison and advisor to various Strive roles and departments such as kidney heroes, operational leadership and managers, education and training colleagues. You will serve as a care manager and quality subject matter expert, applying critical thinking and decision-making skills to determine medical appropriateness while maintaining production goals and Quality Assurance standards. This role reports to the Sr. Manager, Clinical Quality Performance.

Minimum Qualifications: Active, unrestricted NP license. 6+ years combined of related education, experience, or certification. Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency Ability to travel and be onsite to meet business needs. Preferred Qualifications: Application of NCQA program(s) accreditation standards and processes experience. Experience in GDMT protocols along with knowledge of proper care of patients with multiple complex medical conditions. Familiar with documentation and coding standards for HCC and HEDIS. NCQA Accreditation Survey experience or other industry related audits. Proficiency in Microsoft Office, Adobe Acrobat and internet/web navigation. Case Management Certification. Knowledge of the organization of medical records, medical terminology, and disease process. About You: Strong clinical assessment and critical thinking skills. Attention to excellence - quality driven, detailed oriented, innovative, and accountable. Excellent verbal and written communication skills. Ability to work in a team environment. Flexibility and strong organizational skills needed.

Review clinical documentation and encounters (assessments/surveys, plans of care, recorded encounters) to ensure alignment with clinical guidelines, NCQA standards, and industry best practices. Meet auditing productivity targets (daily/weekly/monthly) while maintaining quality assurance standards. Validate timeliness and accuracy of internal assessments and plans of care against NCQA Case Management and Population Health requirements. Communicate audit findings and provide coaching/education to Kidney Heroes and clinical leaders, clearly documenting deficiencies and improvement opportunities. Develop and maintain audit tools and resources by supporting updates to processes, templates, and guidance materials. Identify, support resolution, and escalate risks/gaps impacting quality, compliance, safety, or accreditation readiness. Flag system or operational barriers that impede attainment of quality performance standards and recommend improvements. Accurately abstract and submit audit documentation using designated tools and route required materials to appropriate stakeholders. Support compliance and accreditation activities (case prep/review, action plans) while maintaining HIPAA confidentiality and professionalism.

Alight Solutions

Clinical Case Manager-RN

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Case Management

License:

RN

State License:

New Jersey

At Alight, we believe a company’s success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to “Be Alight.” We are passionate about connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management. Our Benefits With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and vision coverages starting Day One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities – all within a thriving global organization. Flexible Working So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and “Top 100 Company for Remote Jobs” 6 years in a row. Great Place to Work Thanks to the work of every colleague, Alight has received multiple awards of recognition including “Great Place to Work” for the past 7 years and Fortune’s “Best Companies to Work For.” To learn more about our company culture and awards Click Here. If you, Champion People, seek to Grow with Purpose, and embody the meaning of Be Alight – We invite you to join our team! Learn more at careers.alight.com .

The Clinical Case Manager-RN will offer clinical expertise, act as a liaison in disability cases, and utilize MDGuidelines to support medically sound decisions. They will ensure effective administration of absence and disability claims while delivering compassionate care to client employees.

Be a Registered Nurse, Nurse Practitioner, or comparable license with experience, with working knowledge of disability, client processes, and case management. Have minimum of 5 years medical advisory experience in occupational health, worker compensation, disability, health case management, or utilization review. Have minimum of 2 years' experience as a Clinical Case Manager. Demonstrate dedication to providing high quality customer service, using diplomacy, patient advocacy, and professional competency. Foster interest in collaborating with compassionate clinicians and leaders who prioritize mutual care and the well-being of customers and employees. Have relevant education and valid licensure.

Serving as primary resource on team managing medical disability and accommodation cases. Delivering case presentations to a panel, utilizing compelling communication, critical thinking, negotiation, holistic case analysis, and proactive case management skills. Displaying a professional/corporate presence and presentation style with the ability to demonstrate excellent problem-solving skills when questioned on your case management plans. Consulting on medical, behavioral health, and accommodation claims as needed, if within the scope of licensure and clinical expertise. Supporting employee-clients in making informed decisions through patient advocacy aligned with Medical Disability Guidelines (MDG), employer benefit plans, and disability management regulations. Acting as a liaison between all parties required in case management to facilitate continuous communication and consensus. Serving as a liaison to the client's EAP, coordinate care, and encourage referrals to top behavioral health providers. Providing documentation, feedback, and reports to diverse occupational populations with an underlying emphasis on returning medically able individuals to productive endeavor. Managing caseload efficiently, organizing priorities, provides timely interventions, and maintains sensitivity to confidential records. Driving return to work process from beginning of case to closure. Ensuring quality standards for case management are met; implement Alight’s continuous quality improvement process whenever efficiencies or quality standards are not met.

Verita AI

Case Management Nurse (Epic EHR Expert)

Posted on:

May 20, 2026

Job Type:

Contract

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

Verita AI builds high-trust data pipelines that enable AI systems to understand real-world workflows across healthcare, finance, and operations. We work with domain experts to help frontier AI systems reason through complex operational tasks the same way experienced professionals do in practice. Our founding team includes alumni of Mercor, Hudson River Trading, Citadel, IDEO, Stanford, and Yale. We partner with leading AI labs and researchers advancing the next generation of intelligent systems.

We are hiring Utilization Review and Case Management Nurses with Epic EHR experience to help train and evaluate advanced AI systems on real-world patient review and care coordination workflows. This role focuses on medical necessity review, level of care evaluations, payer authorization processes, discharge planning coordination, and patient chart analysis. You will help AI systems better understand how utilization management and care coordination workflows function inside modern healthcare environments. Hourly Rate: $108/hr

Requirements: 2–6+ years of professional Epic EHR experience in utilization review, case management, or clinical operations RN background with experience reviewing patient care workflows and payer authorization processes Strong familiarity with medical necessity review and level of care decision-making Ability to navigate patient charts, clinical notes, and healthcare documentation workflows accurately Strong written communication and operational reasoning skills High attention to detail and workflow consistency Preferred Backgrounds: Candidates with experience in the following areas are especially encouraged to apply: Utilization Review Case Management Care Coordination Discharge Planning Payer Authorization Hospital Nursing Operations Clinical Documentation Review Medical Necessity Evaluation Experience with CCM credentials, InterQual, MCG criteria, or payer review workflows is a plus.

Review AI-generated utilization review and patient management scenarios for operational accuracy Evaluate Epic workflows involving chart review, payer authorization, and care coordination Analyze healthcare scenarios tied to medical necessity, discharge planning, and utilization management Translate real-world patient review workflows into structured AI evaluation tasks Provide detailed written feedback on healthcare operational workflows and clinical reasoning Document workflow decisions clearly and consistently across patient review scenarios

Ascend Learning

Nurse Practitioner Educator

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Education

License:

NP/APP

State License:

Kansas

Ascend Learning, a leading healthcare and learning technology company, is the connection between a powerful portfolio of brands serving students, educators, and employers with outcomes-based, data-driven solutions across the lifecycle of learning. From testing to certification, Ascend Learning products are used by physicians, emergency medical professionals, nurses, allied health professionals, certified personal trainers, financial advisors, skilled trades professionals and insurance brokers. Headquartered in Burlington, MA, with additional office locations and hybrid and remote workers in cities across the U.S., Ascend Learning was recognized by Newsweek and Plant-A Insights Group as one of America’s 2025 Greatest Workplaces as well as America’s Best Places to work for Mental Well-Being for 2025.  We're always looking for talented, passionate professionals to join us in our mission to help change lives. If this sounds like an environment where you'd thrive, read on to learn more.  Ascend Learning's Nursing Category is fueled by a commitment to excellence as we support the full learning journey of future nurses. Our nursing brands — ATI, APEA, and NursingCE — offer evidence-based solutions designed to develop practice-ready nurses who are prepared for board certification and clinical practice. We use data analytics and engaging learning tools to help nursing students master core content. And we provide nursing education administrators and faculty with best-in-class support and expertise from some of the sharpest minds in nursing education. We aid nurse educators in understanding students' comprehension based on nearly two decades of data — including more than 12 million proctored assessments — that detail student learning and performance. The result is customers who are confident in their program offerings and positioned for healthy outcomes.

The Nurse Practitioner Educator is a high‑impact role responsible for delivering live nurse practitioner certification review courses both onsite and online, while creating and curating high‑quality, evidence‑based content across multiple certification tracks. This role collaborates with cross‑functional teams to develop and update certification prep materials, delivers immersive exam review experiences for APRN students, and partners with product and editorial teams to address market needs through effective educational solutions. As a subject matter expert, the educator also serves as a thought leader, contributing to product strategy, team development, and external engagement through conferences, training, and professional content. WHERE YOU’LL WORK This role offers the flexibility of remote work within the United States with an expected 60% travel commitment during peak seasons to support onsite live review course delivery and in‑person educator training across the U.S.

Master’s degree in Nursing required; doctoral degree (DNP or PhD) preferred. Current, active national APRN certification (AANP or ANCC) in good standing as a Family Nurse Practitioner (FNP) or Psychiatric Mental Health Nurse Practitioner (PMHNP); dual certification preferred. Minimum of three years of experience as an academic NP educator or preceptor, supporting NP students in didactic or clinical learning environments. Demonstrated experience as a podium presenter at state and/or national conferences, with the ability to deliver engaging, high‑impact educational content to professional audiences. Expertise with NONPF Competencies and NTF Standards for APRN education. Active clinical practice (full‑time or part‑time) within the past five years, ensuring currency with contemporary NP practice standards. Certified Nurse Educator (CNE) credential preferred. Deep expertise in nurse practitioner practice and nursing education, with current knowledge of APRN clinical, educational, and certification trends. Proven ability to deliver engaging live education in both in‑person and virtual formats, translating complex clinical content into clear, learner‑centered instruction. Strong emotional intelligence and collaboration skills, including the ability to build rapport, adapt communication styles, and work effectively with cross‑functional teams and stakeholders. Proficient in applying adult learning principles to live instruction, content development, assessment, and remediation. Ability to develop high‑quality educational content across core and population‑focused NP curricula accurately and on time. Highly organized, adaptable, and effective in a remote, fast‑paced, business‑driven environment; comfortable with up to 60% travel and proficient with common virtual and presentation technologies. Technologically proficient, including strong working knowledge of Teams, PowerPoint, Zoom, Microsoft Word, Excel, and virtual presentation and engagement platforms.

Serve as a subject matter expert in advanced practice nursing, maintaining deep, current knowledge of NP clinical practice and national certification standards. Deliver high‑quality, engaging, certification‑focused live review courses for nurse practitioner students, both onsite and online, serving as a lead instructor and mentor to the part time educators and as a trusted clinical educator. Develop, update, and curate educational content across multiple learning modalities, including live review presentations, and other strategic content such as: tutorials, case studies, clinical updates, and assessment items with evidence‑based rationales. Monitor emerging APRN practice trends, certification blueprint updates, and market needs to inform content strategy and drive innovation in educational products that support APRN program and learner outcomes. Maintain and continuously improve existing product lines to ensure alignment with current clinical guidelines, best practices, and evolving NP practice standards. Act as a professional thought leader by representing APEA, ATI, and Ascend Learning at professional conferences, meetings, and internal forums, contributing to faculty development, product strategy, and brand credibility.

Ascend Learning

Nursing Education Specialist

Posted on:

May 20, 2026

Job Type:

Full-time

Role Type:

Education

License:

RN

State License:

Kansas

Ascend Learning, a leading healthcare and learning technology company, is the connection between a powerful portfolio of brands serving students, educators, and employers with outcomes-based, data-driven solutions across the lifecycle of learning. From testing to certification, Ascend Learning products are used by physicians, emergency medical professionals, nurses, allied health professionals, certified personal trainers, financial advisors, skilled trades professionals and insurance brokers. Headquartered in Burlington, MA, with additional office locations and hybrid and remote workers in cities across the U.S., Ascend Learning was recognized by Newsweek and Plant-A Insights Group as one of America’s 2025 Greatest Workplaces as well as America’s Best Places to work for Mental Well-Being for 2025.  We're always looking for talented, passionate professionals to join us in our mission to help change lives. If this sounds like an environment where you'd thrive, read on to learn more. 

As a Nursing Education Specialist, you will combine your experience as a prelicensure nursing educator with comprehensive generalist nursing knowledge to develop content solutions that meet real world learning needs. In addition to generalist nursing knowledge, focused areas of expertise in one or more of the following specialty nursing areas is required: adult medical-surgical, mental health, maternal–newborn, or pediatrics. The Nursing Education Specialist uses a variety of resources, including database searches and literature reviews, to author original content and update existing content. This individual must have strong writing skills, proficiency with test blueprints and the NCSBN®, and an understanding of prelicensure nursing curricula. This position exists to provide accurate, evidence-based content across products and provide input on product development. WHERE YOU’LL WORK This position has the flexibility of remote work within the United States. Occasional travel will be required.

MSN and current RN license required. Five years of experience as a full-time faculty member in a prelicensure nursing program (responsible for teaching both theory and clinical). Three years of clinical nursing practice experience in adult medical surgical or mental health or maternal newborn or pediatric nursing. Expertise teaching prelicensure adult medical surgical or mental health or maternal newborn or pediatric nursing, as well as the ability to create generalist-level content across the nursing curricula. Knowledge of current nursing practice and trends in prelicensure nursing education. Knowledge of and ability to align products with the NCLEX-PN® and NCLEX-RN® detailed test plans. Excellent writing skills. Ability to conduct literature searches using a variety of research databases and search engines. Ability to analyze research articles and other resources to create professional-level, original content. Ability to write multiple choice, alternate format, and Next Generation NCLEX® style items following an assessment blueprint. Proficient with Microsoft Office products, Adobe Acrobat, and the internet.

Create original and review or update existing nursing content to ensure alignment with current evidence-based practice. Content includes assessment items, tutorials, simulations, and/or other products as defined. Demonstrate strong presentation, organizational, problem-solving, and communication skills while working with cross-functional teams. Balance multiple projects and tasks while meeting ongoing and overlapping deadlines. Lead and/or participate in item review meetings with internal or external subject matter experts. Respond appropriately to internal and external client inquiries in a timely fashion. Assist with training and coordinating internal and external contributors on projects. Conduct beta testing and quality assurance checks on products prior to release.

MUSC Health

Clinical Documentation Specialist I - RN-2

Posted on:

May 19, 2026

Job Type:

Full-time

Role Type:

Clinical Operations

License:

RN

State License:

Compact / Multi-State

As the health care system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest quality and safest patient care while educating and training generations of outstanding health care providers and leaders to serve the people of South Carolina and beyond. In 2025, for the 11th consecutive year, U.S. News & World Report named MUSC Health the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.

Entity: Medical University Hospital Authority (MUHA) Worker Type: Employee Worker Sub-Type​: Regular Cost Center: CC005073 CHS - Clinical Documentation Pay Rate Type: Salary Pay Grade: Health-28 Scheduled Weekly Hours: 40

Bachelor's degree in nursing from an accredited school of nursing and at least five years' clinical nursing experience preferred. Strong clinical experience and critical thinking skills required. Extensive knowledge of patient care, and knowledge of clinical measurement tools and clinical outcomes; ability to establish cooperative working relationships with diverse groups and individuals, medical staff and other health care disciplines. Licensure as a registered nurse by the South Carolina Board of Nursing or compact state. Position may require extensive walking. May require frequent bending, stooping, or stretching. May require lifting and carrying up to 20 lbs. Requires eye-hand coordination and manual dexterity. Requires the use of office equipment, such as computer terminals, telephones, and copiers. Requires normal vision range and the absence of color blindness. Continuous – 6-8 hours per shift; Frequent – 2-6 hours per shift; Infrequent – 0-2 hours per shift Ability to perform job functions while standing. Ability to perform job functions while sitting. Ability to perform job functions while walking. Ability to climb stairs. Ability to work indoors. Ability to work outside in temperature extremes. Ability to work from elevated areas. Ability to work in confined/cramped spaces. Ability to perform job functions from kneeling positions. Ability to bend at the waist. Ability to twist at the waist. Ability to squat and perform job functions. Ability to perform “pinching” operations. Ability to perform gross motor activities with fingers and hands. Ability to perform firm grasping with fingers and hands. Ability to perform fine manipulation with fingers and hands. Ability to reach overhead. Ability to perform repetitive motions with hands/wrists/elbows and shoulders. Ability to fully use both legs. Ability to use lower extremities for balance and coordination. Ability to reach in all directions. Ability to lift and carry 50 lbs. unassisted. Ability to lift/lower objects 50 lbs. from/to floor from/to 36 inches unassisted. Ability to lift from 36” to overhead 25 lbs. Ability to exert up to 50 lbs. of force. Ability to see and recognize objects close at hand or at a distance. Ability to match or discriminate between colors. Ability to determine distance/relationship between objects; depth perception. Good peripheral vision capabilities. Ability to maintain hearing acuity, with correction. Ability to perform gross motor functions with frequent fine motor movements. Ability to deal effectively with stressful situations. Ability to work rotating shifts. Ability to work overtime as required. Ability to work in a latex safe environment. Ability to maintain tactile sensory functions.

The RN (Registered Nurse) – Clinical Documentation Specialist I report to their respective Manager, Clinical Documentation. Under general supervision, the RN – Clinical Documentation Specialist I conduct reviews of inpatient electronic medical records to identify missing, vague, and/or incomplete diagnoses and collaborate with and facilitate appropriate provider documentation to accurately reflect appropriate DRG (Diagnosis Related Group) assignment, patient severity of illness and risk of mortality. In addition, the CDI (Clinical Documentation Integrity) specialist risk adjusts for expected mortality/length of stay and clinically validates key diagnoses. The RN – Clinical Documentation Specialist I is responsible for a baseline understanding of interpreting quality metrics and participates in appropriate ICCE meetings, QAPIs, and/or other identified educational opportunities across the system.

Verse Medical

Clinical Documentation Review Nurse

Posted on:

May 19, 2026

Job Type:

Full-time

Role Type:

Utilization Review

License:

RN

State License:

Compact / Multi-State

The healthcare industry still relies on faxes and phone tag to coordinate critical care for patients at home. We think patients and the clinicians who serve them deserve better than a system stuck in 1995. Verse Medical is building the modern software infrastructure to make it happen. We're a well-funded Series C company (backed by General Catalyst, SignalFire, and Sapphire Ventures) on a mission to heal a fragmented system. Our platform connects the dots between providers, payors, and patients, ensuring people get the high-quality care they need, reliably and right where they live. We’re growing fast and looking for people who are driven by this mission to join us! Our Values: The Principles That Guide Us Our values are the operating system for how we work together and with our partners. They aren't just words on a wall; they are the principles we bring to every decision, every day. We are transparent, upfront and direct. We operate with honesty and clarity. We share information openly, the good and the bad, and believe that direct, respectful feedback is the foundation of trust and progress. We value speed of iteration. We are building something new, which means we learn by doing. We prioritize rapid iteration and getting solutions into the hands of users, believing that progress is more valuable than perfection. We give 110% effort, 30% of the time. We are passionate about our mission, and there are moments that require us to go the extra mile. We believe in focused intensity when it counts, balanced by a sustainable pace that keeps our team energized for the long run. We empathize with customers to a fault. When our users face a problem, we own it. Instead of asking them to change, we ask ourselves, "How can we make this better?" We believe true innovation comes from deep empathy and a relentless focus on solving the real-world challenges of healthcare.

We are building a high-performing clinical review operation to support documentation and compliance for durable medical equipment (DME), starting with surgical dressings. This role sits at the intersection of clinical judgment and operations. You will utilize our internal software and your clinical background to evaluate patient documentation against structured coverage criteria, identify gaps, and produce clear, standardized review outputs at high throughput. This is not a traditional bedside or case management role. Success in this role requires attention to detail, comfort with structured workflows, and the ability to operate efficiently at scale.

Required: Active RN license (BSN preferred but not required) 2+ years of clinical experience OR prior utilization review / documentation review experience Extremely strong attention to detail Fast learning rate of new concepts Ability to follow structured workflows and apply rules consistently Comfort working in a high-throughput, metrics-driven environment Strong written communication skills DME, Medicare regulations/surgical dressing reviews preferred but not required

Review patient charts and documentation against defined coverage criteria Work with internal AI software that enables review productivity Apply structured processes to determine documentation sufficiency Identify missing or inconsistent documentation and flag appropriately Produce clear, standardized written summaries of review outcomes Meet daily throughput and quality targets (e.g., reviews/day, QA pass rates) Incorporate feedback from QA and continuously improve accuracy and speed Collaborate with product team to refine software over time

Sagility

Associate Manager US Clinical Operations RN

Posted on:

May 19, 2026

Job Type:

Full-time

Role Type:

Clinical Operations

License:

RN

State License:

Colorado

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

The role of an RN Assistant Manager Operations is to assist in managing overall account performance and financial profits by coaching and developing Supervisors to deliver quality performance. Managing Supervisors to ensure day to day operations are successful. Location: Work@Home USAUnited States of America

Education: Associate degree or diploma in nursing. Bachelor’s degree in nursing preferred Experience: 3 years experience in a clinical call center environment or telehealth environment preferred. 2 years of leadership experience Healthcare preferred Mandatory Skills: Active, unrestricted nursing license (for nurses) Strong management, interviewing, hiring, coaching, and counseling skills Ability to manage multiple projects to successful and timely completion Excellent communication skills; written, verbal Strong presentation skills Demonstrated sound problem-solving analytical and decision-making skills Knowledge of quality improvement processes Possesses leadership qualities of courage, integrity, the ability to motivate others and the ability to promote harmony in the workplace Works effectively leading a team and participating on a team Strong member advocate: willing to go above and beyond normal responsibilities to provide the best service possible Ability to assist member in navigating the healthcare system and community-based resources. Culturally sensitive and competent regarding membership served Ability to work remotely Ability to determine when to escalate issues appropriately and in a timely manner. Proficient computer skills. Thorough knowledge of case management. Knowledge of/experience in disease management. Understanding of family and group dynamics. Familiarity with change behavior techniques. Demonstrates empathy Must have experience managing teams in a virtual environment Preferred Skills: Basic financial acumen (cost-effectiveness, cost-benefit etc.)

Shift Management Function: Accountable for the shift operations. Ensures execution of contingency and disaster recovery plans. Ensures Contact Center meets productivity standards and client service levels are met or exceeded. Reviews and analyses productivity reports prepared by the team leaders before the reports are submitted to the Operations Manager. Submits periodic productivity/service performance reports to the Operations Manager. Prepares the schedule /Team Leaders assignments to ensure that all operational hours are supervised. Regularly conducts dialogues, communication sessions with agents/front liners (skip meetings). Ensures that workplace is safe, conducive, and a healthy working environment. Implements operational management policies in order to ensure adherence to service level agreements between clients. Coordinates with workforce with regards to approval/disapproval of request for unscheduled leaves and tardiness and the necessary adjustments to schedules of available manpower in order to meet requirements. Ensures preparation of client required reports and makes necessary endorsements to ensure that deadlines for submission of reports are met. Be able to analyze and recommend measures in order to meet set metrics based on trends. Ensures all team monitor service calls to observe employee’s demeanor, technical accuracy, and conformity to company policies. Be able to ensure that operations run smoothly on a daily basis. Be able to coordinate with Workforce to ensure Service Levels and program goals are met. Recommends corrective services within client limits to adjust customer complaints. Answers questions about service to Team Leaders and works to develop so repeat questions do not arise. Strives to help the entire team when in need of assistance. *Communicates policy changes, program developments, and company news to their respective teams, supporting the business decisions while supporting the staff in any required adjustments Clinical Management Function: Takes escalated calls to resolve provider and member concerns that cannot be handled by supervisors and front-line staff. Follows through with pending client escalations’ requests (example: pre-authorization requests) requiring supervisor’s assistance; reviewing outcome of case rework prior to handing it over to the clients. Quality Management/Standards Compliance Function: Conducts performance reviews and appraisals for Team Leaders (monthly/midyear/yearly). Reviews preliminary investigation of disciplinary cases and approves/disapproves/escalates disciplinary actions in adherence to the provisions of the Company Code of Conduct. Conducts regular inter and intradepartmental operations, feedback, action planning, meetings for dissemination of policies and products, hardware issues, troubleshooting, review of status reports, etc. Participates in the development of contingency plans, escalation procedures, and disaster recovery plans. Regularly reviews staffing requirements, actual headcount vs. budget, and requisitions for manpower when necessary. Ensures implementation of customer complaint escalation and turnaround time for complaint resolution to meet service level agreements. Participates in the preparation of the department’s annual business plan and budget to support Sagility’s objectives and goals. Ensures operation’s compliance with the client’s requirements and policies. Provides recommendations in the setting of call center systems pameters. Be able to implement action plans to ensure alignment between the other support groups. Be able to communicate as needed with other departments within the Contact Center about operational and personnel needs. Be able to analyze situation arises outside the established guidelines or parameters and be able to evaluate such situation for impact on present. Be able to give recommendations and implement these recommendations once approved to ensure process improvement in order to help the program achieve its goals. Studies and standardizes procedures to improve efficiency of subordinates. Informs all parties when system is not working effectively. Works with call center Director to develop better ways for system to improve quality. Be able to be responsible in the performance of his/her team. Responsible for the development and implementation of policies and procedures pertaining to HIPAA and ensures the center follows Privacy Rules Standard Staff Development Function: Be able to provide bi-monthly one-on-one coaching and feedback to drive performance and reduce cost. Be able to provide immediate coaching regarding TL or team performance when the need arises using documented personal observations or critical incidences to improve TL and team performance. Be able to ensure timely and accurate communication regarding updates to team leaders. Be able to initiate and support all employee satisfaction and workplace programs. Disciplines and creates incentives for all staff in conjunction with meeting performance measurements. Be able to answer questions about service to the Team Leaders. Be able to recommend and apply corrective measures for staff members who do not meet minimum performance metrics. Be able to monitor key performance indicators within and across teams to assure that standards are met across the board. Be able to work with Team Leaders to resolve concerns of agents as well as their own. Be able to follow-up personnel issues (e.g. Payroll, HR, etc.) as reported by TLs. Be able to meet with TLs at least once a week to discuss program and team performance and share best practices. Be able to ensure TLs submit accurate and timely reports (ex. Coaching logs, performance review, etc.). Be able to create specific Individual Development Plans for TLs over a given period of time to prepare them to the next level. Administrative Function: Be able to file accurate and timely agent coaching logs from TLs. Be able to file the weekly / monthly team performance reviews. Be able to implement programs to ensure high levels of Quality. Be able to develop initiatives to optimize results. Be able to partner with other Shift Managers to share / implement best practices. Be able to monitor team performance in Chronicle on a daily basis. Submit weekly and monthly team operations review to Operations Manager. Others: Perform tasks assigned by the Operations Manager. Prepare composite reports from the individual reports of subordinates. Communicate as needed with other departments within the Contact Center about operational and personnel issues. Interviews and staff supervisor team. Handle the overall project, Budgeting & Financials, Strategies to improve teams KPIs, SPOC for the client relations, profitability of the project, Planning & Process improvements. General Safety and Security: Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS) Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), HITECH Act and URAC The above statements are intended to indicate the general nature and level of work being performed by employees within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job. Employees in this job may perform other duties as assigned.

CenterWell Home Health

Care Manager, Telephonic Nurse-Part Time Evenings & Weekends

Posted on:

May 19, 2026

Job Type:

Part-time

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.

Shift/availability details: Part time 20 hours a week. The schedule is Monday-Thursday from 5:30pm-8:30pm EST and Saturday from 8am-4:30pm EST. Required to work a rotating holiday schedule. This is a work-from-home telephonic Registered Nurse position. As a Care Manager, Telephonic Nurse, you will report directly to the Manager, Care Management. You will help to ensure optimal continuity of care for patients transitioning into and out of our services. You will be responsible for being knowledgeable regarding post-acute levels of care, and an expert regarding CenterWell Home Health services including home health, hospice, and palliative care. You will communicate with the CenterWell Home Health clinical team and help facilitate patient follow-up for patients in need of (additional) services.

Required Experience/Skills: Associates Degree required. BSN preferred. We require a compact state RN license. Business needs may require additional state licensures be obtained. At least 3 years post-acute nursing experience. Home health or hospice experience preferred. Knowledge of home health, hospice, and palliative care services. Learn and master information related to locations and services of clients. Analytical and can problem-solve. Excellent verbal and interpersonal skills. Communication with empathy over the phone. Must read, write and speak fluent English. Current CPR certification. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required

Be a CenterWell Home Health representative in supporting patients who have been discharged from service or for those who may need post-acute services. Navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, and accessing healthcare resources. Use a variety of tools and methods to quickly provide patient options and education including but not limited to sites of service, specialty offerings, post-acute care, and other related questions. Handle a variety of customer issues including location lookup, directions, and complaints. Make clinical level of care determination based on discussion, medical records, and any other important clinical data. Match these needs to a service site location or, if not available, look up and provide alternative services. Be a customer advocate throughout the referral process to ensure timely response and to maximize referral to admission conversion rate. Follow-up and track referral and admission outcomes. Maintain awareness and orientation to department performance objectives, meets standards, and assures patient satisfaction goals are met. Assist in the admissions process by acting as an ambassador for patients who meet the admissions requirements. Focus on placing the right patient to the right care setting at the right time Adhere to and participates in Company's mandatory training which includes but is not limited to HIPAA privacy program/practices, Business Ethics and Compliance programs/practices, and Company policies and procedures. Review and adhere to all Company policies and procedures. Provide education regarding Home Health, Hospice, and Palliative Care Services. Help with clinical eligibility review for alternate services Participate in special projects and perform other responsibilities as assigned.

Neighborcare Health

Family Medicine Registered Nurse, Triage & Advice (.6 -.8 FTE)

Posted on:

May 19, 2026

Job Type:

Full-time

Role Type:

Triage

License:

RN

State License:

Washington

Since 1968, Neighborcare Health has been removing barriers to health care for our neighbors. We believe everyone deserves a place to call their health care home, where a team of medical, dental and mental health professionals work in collaboration with each patient to develop a personal health improvement plan. We are one of the largest providers of primary medical, dental and behavioral health care services in the Seattle area serving low-income and uninsured families and individuals, seniors on fixed incomes, immigrants, and people experiencing homelessness. Each year we care for nearly 60,000 patients at our nearly 30 non-profit medical, dental and school-based clinics. We ask everyone to pay what they can, but no one is turned away due to inability to pay. Our clinics are located in neighborhoods where health disparities are the greatest, and our care teams, who speak over 55 languages and dialects, are as diverse as our patients. No matter who you are, or where you come from, regardless of your insurance, income or immigration status, you are welcome at Neighborcare Health.

The Primary Care Registered Nurse works in partnership and joint accountability within an interdisciplinary team to achieve Neighborcare’s Mission, Guiding Principles and goals. The primary focus of the RN is to optimize the health status of patients across the lifespan through working in partnership and joint accountability, patient education, emergent triage, and performing complex procedures. RNs build relationships with their patients through face-to-face, virtual, and telephonic care and work in partnership with other care team members to meet the needs of patients throughout Neighborcare Health. The RN follows the Nursing Process to assess, diagnose, plan, implement and evaluate nursing care in an outpatient clinic setting. Remote work schedule for candidates local to the Seattle Metropolitan area. Health, Wellness & Retirement benefits: Medical, dental & vision insurance Paid time off & paid holidays Retirement with contribution match Life & AD&D, pet insurance Employee assistance program, & more! Union: SEIU Healthcare 1199NW Compensation: The target wage range for the position is $38.71 per hour to $47.88 per hour. Final offers are individually based on various factors, including skill set, years of experience, location, qualifications, work schedule and other job-related reasons. $5,000 Sign-on Bonus!

Clinical Knowledge & Skills: Knowledge and understanding of a broad range of physical and mental health conditions across the lifespan. Knowledge, skill, and ability to provide condition- and population-specific education and coaching, including but not limited to wound care, foot care, and injections. Knowledge of medical terminology and clinical procedures; anatomy, physiology, biology, human growth and development; asepsis and universal precautions; medical documentation. Ability to start and operate emergency equipment, perform CPR, provide basic first aid, and respond professionally in emergent situations. Ability to demonstrate sound clinical judgment and work resourcefully and independently in the absence of detailed instructions. Ability to self-assess knowledge and nursing skill and continuously develop clinical expertise through Neighborcare Health and community-based continuing education. Patient & Interpersonal Skills: Ability to work effectively with patients and communicate respectfully with individuals from varied cultures, languages (including through interpreters), educational and socio-economic backgrounds, as well as individuals with disabilities and contagious diseases. Ability to work effectively independently and as part of a team, interact appropriately with co-workers and patients, and develop and maintain rapport with a wide range of individuals. Ability to comply with HIPAA/Confidentiality policies and handle confidential and sensitive patient and staff information. Skills in written and verbal communication in English and basic math. Professional & Technical Attributes: Ability to demonstrate reliable and timely attendance. Willingness to travel to clinic with the most need based on Nurse Manager staffing. Ability to demonstrate flexibility, adaptability, willingness, and openness to learn and change. Ability to follow written and verbal directions and complete assigned tasks in a timely manner. Ability to work with supervision, receiving instructions/feedback, coaching/counseling and/or action/discipline, and learn from directions, observations, and mistakes. Preferred Skills: Skills in Motivational Interviewing and application of a harm reduction model Skills in care for chronic wounds, including conservative sharp debridement Knowledge of unique health needs of specific patient populations pertinent to the role/site Knowledge of community resources Education/Experience Requirements: Completion of an accredited RN program Valid Washington State Registered Nurse license BLS certificate Preferred Requirements: BSN desirable 1+ years RN experience in a primary care, hospital and/or home care setting or comparable social service setting Board Certification in applicable specialty areas

Working in Partnership and Joint Accountability: Provide care to patients in the outpatient clinic setting as part of Neighborcare’s nursing team, maintaining shared accountability with the clinic team and the medical program as a whole. Collaborate with team members and leaders to define and reassess priorities, and to plan, communicate, and execute patient care. Participate in quality and performance improvement initiatives to improve patient outcomes. Serve as a preceptor for new staff and/or students completing clinical rotations at Neighborcare. Patient Care & Health Management: Partner with patients and families in person, virtually, and by phone to support optimal health outcomes. Identify patient goals for improving health status and managing chronic physical and mental health conditions. Apply the nursing process (assess, diagnose, plan, implement, evaluate) to meet patient needs. Assess patient understanding of their condition and readiness for behavior change. Deliver wound care, foot care, chronic disease management, and ongoing injections. Monitor, track, and follow up to ensure care needs are met. Apply Neighborcare Health guidelines, standing orders, and evidence-based clinical practices. Patient Education: Provide education across the lifespan. Identify barriers to learning and tailor education to patients’ individual needs and learning styles. Educate patients on medications, abnormal lab results, and management of acute and chronic conditions. Promote preventive care and wellness strategies. Use motivational interviewing and harm reduction counseling to support patient-centered care. Triage & Clinical Procedures: Respond to emergent health issues in person and by phone; provide assessment, advice, first aid, and Basic Life Support as needed. Perform clinical procedures within RN licensure and individual competency, which may include wound care, foot care, IM injections, IV insertion and administration of fluids/medications, and urinary catheter insertion/removal. Administer injections and medications per standing orders and protocols. Triage and Advice Registered Nurse: Work remotely or can request a location at a Neighborcare location receiving incoming calls from patients as directed by call center and contacting patients identified for triage. Conduct telephone triage using standardized protocols and clinical judgment to assess patient symptoms and determine appropriate disposition (self-care, urgent/same-day visit, ER/911, etc.). Provide education and reassurance to patients and families regarding acute health concerns. Document triage encounters promptly and accurately in the electronic health record. Collaborate with providers and clinic staff to facilitate timely access to care. Escalate high-risk or complex cases to providers as appropriate. Address and manage patient messages (MyChart, call center, Inbasket pools) within designated timeframes. Family Practice/Medicine Registered Nurse: Rotate between clinics, programs, and patient populations based on organizational needs and training. Assignments will be made by the Nurse Manager. Provide anticipatory guidance and education to families regarding development, preventive care, and wellness. Support families with multiple members receiving primary care by aligning care plans and facilitating communication. Work closely with providers to support all ages and all health needs. Participate in activities to support preventive care and family health. Provide hands-on nursing care including wound care, foot care, and controlled substance injections. Partner with Care Management RNs to provide in-person care to identified patients.

Connexall

Clinical Informatics Specialist – RN

Posted on:

May 19, 2026

Job Type:

Full-time

Role Type:

Informatics

License:

RN

State License:

Florida

GlobeStar Systems is a leader in integrated clinical communication. Our cornerstone product, Connexall®, is an award-winning Enterprise grade IoT platform, purpose built for the healthcare industry. Connexall® delivers a customizable suite of integration solutions to meet the unique and specific communications requirements of any organization. Connexall® services over 1,500 healthcare providers around the world, helping customers improve clinical workflow and driving better patient and staff outcomes.

Job Title: Clinical Informatics Specialist - RN Type: Full-Time Start Date: Immediate Location: US (Remote) – Preference will be given to candidates located in Central or Western time zones to support business operations. Job Summary: Reporting to the Director of Clinical Services and Outcomes, the Clinical Informatics Specialist - RN will provide professional services and clinical support to our customers throughout the Connexall project lifecycle. The successful candidate combines clinical workflow design, data analytics, application implementation, and customer relationship skills to successfully excel Connexall Software offerings. They will work cross-functionally to ensure the customer’s business and clinical goals are understood and appropriately considered throughout all project phases. Serving as an internal and external subject matter expert and advisor, the Clinical Informatics Specialist - RN provides support and guidance to sales, solutions delivery and product development teams and initiatives.

Current Registered Nurse BSN degree or higher, Master’s preferred. 5+ years clinical experience providing Clinical Practice, Educational Training, and Project Implementation required. Nursing or Clinical Informatics experience preferred. Previous experience with Connexall is an asset. Proficiency in Microsoft Office Suite including Word, Excel, PowerPoint, and Visio. Excellent interpersonal skills, communication skills, and presentation skills with the ability to speak with individuals at all levels of an organization. Excellent documentation and written skills. Ability to convey product features in clinical environments for varying levels of participants. Ability to work with various internal teams and customers to define the scope and content of assigned projects. Must act as a subject matter expert to assist other members of the company, as necessary. Ability to translate technical information into clinically focused training and educational materials. Strong computer skills and technical aptitude. Ability to work independently and as part of a collaborative team. Ability to lead discussions and drive to consensus. Ability to implement quality and workflow improvements in a clinical setting. Ability to align clinical practices and understanding of products into a customized, consultative program for customers. Flexibility in adapting to a rapidly changing, energetic environment. Ability to multitask, establish priorities, work independently, and proceed with objectives without supervision. Passion for redefining healthcare. Must have a flexible schedule and be able to work Mon–Fri, evenings/weekends as needed. Ability to travel about 50% (including overnight travel).

Provide professional services and clinical support to customers throughout the Connexall project lifecycle, including pre-sales demonstrations, solution design workshops, customer workflow analysis and mapping, user training, go-live support, and post-implementation consulting. Serve as a clinical and educational resource both internally and externally during the sales and implementation process. Participate in key account sales presentations, demonstrations, clinical evaluations, and clinical training. Provides clinical expertise across the sales enablement and customer success lifecycle, serving as a subject matter expert on Connexall solutions. This includes offering consultative guidance on clinical workflow optimization, demonstrating the clinical value of the platform, and supporting sales teams in articulating solution impact to prospective customers. Act as a resource to train internal teams, answer clinical product questions, and facilitate highest possible patient outcomes. Document needs assessment, processes, system requirements, dashboard design requirements, change management, and user training materials to ensure successful communication to both technical team and end user. Provide clinical support to customers during implementation, post-implementation, and into project maturity, working with customers to ensure they are maximizing their use of Connexall. Understand customer’s current clinical workflow by conducting interviews with staff in appropriate units, from admittance to discharge. Evaluate current state of customer’s site to determine bottlenecks and inefficiencies, by making clinical workflow observations and documentations and assessing technology tools and HIS systems in place. Work with customer to design and create a schema outlining an updated clinical workflow design, using Connexall to achieve the customer’s desired future state of clinical workflow. Responsible for clinical stakeholder engagement through all stages of implementation ensuring operational readiness and clinical adoption. Support process improvement projects, address clinical workflow concerns, and identify opportunities for improvement. Collaborate internally to communicate opportunities for product improvement using direct customer feedback. Assist with the development of case studies and use cases to share best practices with other customers. Keep up to date with industry standards thereby making recommendations and sharing information that will result in the best practice and use of Connexall. Other duties as required.

Sedgwick

PRN Crisis Care Triage (RN)

Posted on:

May 19, 2026

Job Type:

Part-time

Role Type:

Triage

License:

RN

State License:

Tennessee

Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.

Sedgwick is currently seeking Triage Nurses to join our Crisis Care team. This is a remote PRN position offering up to 20 hours per week. The team operates 24/7, with the greatest staffing needs during afternoon, evening hours, overnight and weekends. Current shift needs (CST) are: 3:00 PM to 9:00 PM 9:00 PM to 6:00 AM, 24 hour weekend shifts - 6:00 AM Saturday - 6:00 AM Sunday or 6:00 AM Sunday to 6:00 AM Monday PRIMARY PURPOSE: Triages incoming catastrophic injury referral calls from clients; gathers vital case details, obtains and provides medical status updates to the customer, and assigns a Field Case Manager (FCM) for onsite visits as appropriate. Ensures that client service guidelines are followed and communicated to the appropriate parties and promotes quality cost-effective outcomes through communication and available resources. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

Education & Licensing: Bachelor's degree in nursing (BSN) from an accredited college or university preferred. Licenses as required. Active unrestricted RN license issued in a state or territory of the United States required. Experience: Six (6) years of related experience or equivalent combination of education and experience required to include three (3) years of recent clinical practice or Telephonic/ Field Case Management experience in Worker’s Compensation. Skills & Knowledge: Strong knowledge of nursing practice and theory Demonstrate a high level of clinical skills and triage ability Ability to apply critical thinking under pressure Knowledge of the insurance industry and claims processing Knowledge of field case management Excellent oral and written communication skills, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Excellent interpersonal skills Excellent negotiating skills Ability to work in a team environment Ability to meet or exceed Performance Competencies WORK ENVIRONMENT: When applicable and appropriate, consideration will be given to reasonable accommodations.

Provides professional and timely responses to incoming catastrophic referral calls from clients, applying all phases of the nursing process, i.e. assessment, planning, implementation, and evaluation when triaging calls. Triages the catastrophic referral utilizing critical reasoning, the department triage log, and associated workflow; utilizes customer specific guidelines to obtain pertinent data. Identifies life-threatening emergencies and recommends appropriate interventions. Assigns appropriate Field Case Manager assignment and facilitates initial onsite hospital visit for the claim. Maintains communication with the customer, Client Service Director, and Claims Examiner providing timely updates on changes in injured worker status and FCM estimated time of arrival. Communicates phone advice in a calm manner, ensuring it is properly received and understood. Ensures triage benchmarks are met, activity is professionally documented and enters incident data into computer system. Educates the assigned FCM on Sedgwick benchmarks and customer specific guidelines. Maintains ongoing communication with the client, Client Service Director, and Claims Examiner until the assigned Field Case Manager arrives onsite. Adheres to quality assurance standards. DDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned.

Capital Blue Cross

Health Navigator - LPN

Posted on:

May 19, 2026

Job Type:

Full-time

Role Type:

Behavioral Health

License:

LPN/LVN

State License:

Pennsylvania

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” The Health Navigator collaborates with members, family, healthcare providers, community resources and other members of the healthcare team to coordinate services and address barriers including access to health care, health literacy, transportation, wellness, gaps in care etc. The Health Navigator will guide members to achieve optimal and vibrant health by providing tools, information, and assistance to help understand their healthcare options, take control of their healthcare needs, bridge the current gap between social-economic and medical and behavioral needs, and navigate the otherwise often confusing steps along the path to efficient and effective care.

Skills: Critical thinking and problem-solving skills; and ability to handle critical situations. Excellent written, oral communication, listening, and organizational skills. Ability to operate a personal computer (PC), including proficiency in Microsoft Office Products. Ability to use computer system while conversing telephonically. Able to demonstrate strong customer service skills, including tact and diplomacy, both in person and telephonically when communicating with internal and external customers. Ability to appropriately prioritize workload and assignments and perform accurate, detailed and timely completion of assigned duties. Ability to work autonomously and as part of an interdisciplinary team Demonstrates sound judgment that affirms the rights and responsibilities of Member’s, families, health care professionals and health care organizations. Knowledge: Knowledgeable on how to navigate all aspects of medical, behavioral, and social systems. Knowledge of NCQA standards for Population Health Management for health plan accreditation, DMAA standards for disease management and CMSA Standards of Practice for Case Management, Act 68, CMS Knowledge of current and emerging medical treatment modalities and best practice guidelines with the ability to analyze and interpret medical and benefit coverage interrelationships. Knowledge of adult learning principles, motivational interviewing and intrinsic coaching techniques. Experience: At least three (3) years’ recent/related experience working in health and wellness promotion, inpatient or other appropriate clinical setting. Behavioral Health experience beneficial but not required. Education And Certifications: Patient Navigation certification preferred or obtained within 1-year employment. Licensed Practical Nurse active license or degree in healthcare related field and 3 years of experience directly related to the duties and responsibilities specified.

Identifying, facilitating, and securing access to needed healthcare, social services benefits and community resources. Assist members with navigating the steps along the path to efficient and effective care. Coordinate appointments with and transportation to physicians and non-physician providers to ensure timely and efficient delivery of diagnostic and treatment services when needed. Actively monitors incoming calls, conducts outgoing calls, and responds to voice mail requests in a timely manner. This could include, but is not limited to, closing gaps in care, HRAs, upcoming education/health events, and provider follow-up. Identify and assess members’ medical, behavioral, social, emotional, and financial needs. Effectively and efficiently utilize the resources available of social, economic, behavioral, and support systems and programs to connect at-risk members with appropriate community resources to address barriers and adherence. Conducts health education. Builds relationships with members, their families, and care givers and provides support in achieving their health care goals. Provide emotional support and/or referring to community-based or physician/provider for greater level of psychosocial intervention Completes education to assigned members and engages them into programs, completes interventions to meet member needs and identifies and refers candidates who require complex interventions to other programs/resources utilizing established criteria and documentation processes to support whole-person care. Completes surveys and assessments for assigned members to support health & wellness needs, and engagement in care programs. Delivers education—basic condition‑specific education, medication adherence, preventive care guidance, and navigation of available health benefits—to empower members in managing their health. Addresses identified gaps in care, reinforce provider care plans, and promote adherence to evidence‑based practices for members. Collaborates with interdisciplinary teams to support whole‑person care, improve quality outcomes, and enhance the member experience. Identifies and reports quality of care issues in accordance with established departmental policies and procedures. Maintains member confidentiality at all times. Documents all care navigator activities in the care management documentation system, according to established policies and procedures. Attends company and departmental meetings and training sessions as required. Assist with assigned population processes including, but not limited to, retrieving and assigning referrals, completing monthly reconciliation report between documentation system(s).

Hummingbird Healthcare

Triage Nurse (Full-time, Remote, Contact Center)

Posted on:

May 19, 2026

Job Type:

Full time

Role Type:

Triage

License:

RN

State License:

North Carolina

We’re elevating patient access so patients can get healthcare how, when, and where they need it. We partner with healthcare systems to transform how patients access care, enabling their providers to focus on what matters most – caring for patients. By managing patient access as a technology-enabled service, we help health systems stabilize costs and improve patient experience while creating good jobs that attract and retain talent in the industry. Our team of experts is obsessed with the connection between the people, processes, and technology that make healthcare organizations hum. Join us and help build the healthcare experience we want for our communities, our families, and ourselves.

Help patients get the right level of care with calm, clinically sound guidance over the phone. As a Triage Nurse at Hummingbird, you’ll be the first clinical voice many patients hear when they’re unsure what to do next. You’ll provide telephone triage in a remote, centralized contact center — assessing symptoms, determining urgency, and guiding patients to safe next steps using client-specific protocols and Epic’s Nurse Triage module. Most of your day will be on the phone managing back-to-back calls, using your nursing judgment and clear guidelines to advise patients, route them appropriately, and support follow-up care. You’ll work with a supportive team of nurses and non-clinical colleagues and receive training, coaching, and feedback to grow your skills, handle increasingly complex scenarios, and continuously improve how we deliver care. The Details Employment Eligibility: Candidates must be legally authorized to work in the United States without sponsorship. FLSA Status: Non-exempt Work Location: Remote. You must work from a location within the United States with consistent Internet service. Wired Internet is required. Schedule: Full-time, Monday-Friday; shifts vary between the hours of 7:00AM - 6:30PM EST Compensation: Expected range is $30.43 - $35.00 per hour. New hires usually start between $31.00 and $33.00, depending on experience and internal equity. Benefits: Comprehensive medical, dental, and vision coverage; paid time off; 401(k); parental leave; career development support; and more Training: Paid, structured onboarding that includes Epic workflows, client-specific protocols, and ongoing education and coaching.

Current, unrestricted RN license in North Carolina; willingness to obtain additional licensure if needed. 1+ years outpatient telephone triage experience or 3+ years clinical nursing experience (ideally primary care, emergency, home health, or med-surg). Strong clinical assessment skills and sound judgment, with the ability to follow standardized guidelines and know when to pause and escalate. Excellent communication skills — you translate complex medical information into clear, patient-friendly language and maintain a calm, steady presence when patients are anxious or unsure. Comfort in a remote contact center setting with back-to-back calls, defined performance metrics, and real-time use of multiple systems (EHR and contact center tools) while documenting and typing ~50 WPM. A strong commitment to patient privacy and strict adherence to HIPAA and all relevant policies. Nice to Have Previous telephone triage or contact center experience Experience using Epic Compact nursing license or eligibility for compact licensure, depending on state and client requirements What Helps You Shine Please note that we use both your resume and your written and oral communication throughout the hiring process to understand your fit for this role. Thoughtful, clear responses help us see your attention to detail, your professionalism, and your ability to communicate with care - skills that are essential for success on our team.

Note: This posting is for our ongoing Triage Nurse Talent Pool. We interview continuously and anticipate frequent openings, with start dates typically 2-6 months after your application. What You’ll Do: In this role, you’ll combine clinical judgment, technology, and communication skills to guide patients safely and efficiently: Provide telephone triage with Epic’s Nurse Triage module, asking focused questions to assess symptoms, rule out red flags, and recommend the right level of care. Verify and update patient information, protect privacy under HIPAA, and coordinate with clinic teams to schedule or adjust appointments and escalate urgent or complex cases. Document calls in real time in the EHR while using Epic and contact center tools to navigate charts, follow protocols, and meet quality and performance expectations. Handle emotionally charged situations with empathy and professionalism, ensuring patients feel heard, informed, and confident about next steps. Take part in ongoing training and continuous improvement, sharing trends and feedback to strengthen workflows, quality, and team culture. Expectations for Focus & Presence: To support patients and each other, this role requires your full attention during scheduled work hours. Our Outside Employment Policy doesn’t allow overlapping work or “job stacking,” so any outside work must happen fully outside your Hummingbird schedule. We’re a camera-ready team, and you’ll need to be on-camera during training and when needed during the workday after training ends. We value connection, teamwork, and being present, which is what keeps our patients safe and our team supported. If that’s what you’re looking for, you’ll feel at home here. If you’re hoping to hold another job during the same hours, this job won’t be the best match.

WelbeHealth

Telehealth Triage RN

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Triage

License:

RN

State License:

California

WelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. We serve the most vulnerable seniors with better quality and compassion in a value-based model. The WelbeHealth Advocate Nurse provides outstanding continuity of care when the PACE center is closed within their scope of practice. The WelbeHealth Advocate Nurse is accountable for answering phones after hours (evening, nights, weekends, and holidays), resolve logistical issues that arise both over the phone and during visits to participants’ residences or acute care settings, and consulting with other clinical staff on call, as needed.

**LOCATION: REMOTE ** SCHEDULE: MON - FRI (WORK EVERY OTHER WEEKEND) **SHIFT: WORK 8 HRS WITHIN THE TIME FRAME OF 8 AM - 12 AM (WEEK 1 & 3 OF THE MONTH = SAME HOURS; WEEK 2 &4 OF THE MONTH = SAME HOURS) This role is different because WelbeHealth Advocate Nurses at WelbeHealth: Work fully remote and are not on call Build relationships with participants rather than providing short-term care We care about our team members. That’s why we offer: Medical insurance coverage (Medical, Dental, Vision) Work/life balance - We mean it! 17 days of personal time off (PTO), paid holidays observed annually, and 6 sick days 401k savings + match Comprehensive compensation package including base pay and bonus And additional benefits We are seeking a WelbeHealth Advocate Nurse that ideally has triaging experience. If you’re ready to join a holistic care team that values both its participants and providers, we’d love to hear from you!

Graduate of an Accredited School of Nursing with an unencumbered RN license Nursing knowledge and skills necessary to treat frail, elderly participants and manage complex clinical situations Highly motivated, self-directed, able to execute tasks in a quickly changing environment, and able to make sound decisions in emergency situations Excellent clinical, organizational, and communication skills in settings with seniors, their families, and interdisciplinary team members Able to work assigned shift which may include days, evenings, nights, weekends, holidays, and overtime

Handle calls (inbound/outbound) as assigned, responding as appropriate within their scope of practice, and consulting with other clinicians, including on-call providers Coordinate telehealth meetings between participants and clinicians Ensure timely care delivery, as well as resolve basic issues, escalating to management as necessary Troubleshoot and effectively resolve logistical care delivery issues relating to aspects such as transportation, medication delivery, and hospital discharge when daytime care teams or responsible central teams are not available Support the clinical care and home health teams to manage smooth care transitions between settings (hospitals, skilled nursing facilities, etc.), escalating changes in participants’ conditions as appropriate

WelbeHealth

TeleHealth RN

Posted on:

May 18, 2026

Job Type:

PART-TIME

Role Type:

Telehealth

License:

RN

State License:

Compact / Multi-State

WelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. We serve the most vulnerable seniors with better quality and compassion in a value-based model. The WelbeHealth Advocate Nurse provides outstanding continuity of care when the PACE center is closed within their scope of practice. The WelbeHealth Advocate Nurse is accountable for answering phones after hours (evening, nights, weekends, and holidays), resolve logistical issues that arise both over the phone and during visits to participants’ residences or acute care settings, and consulting with other clinical staff on call, as needed.

**WORK LOCATION: REMOTE **SCHEDULE: PART-TIME; 20 HRS A WEEK **SHIFT: DAYS/HOURS WORKED FLEXIBLE (MUST BE ABLE TO WORK EVERY OTHER WEEKEND) This role is different because WelbeHealth Advocate Nurses at WelbeHealth: Work a fully remote, flexible schedule Build relationships with participants rather than providing short-term care We care about our team members. That’s why we offer: 401k savings + match 1 hour of sick time accrued for every 30 hours worked We are seeking a WelbeHealth Advocate Nurse that ideally has triaging experience. If you’re ready to join a holistic care team that values both its participants and providers, we’d love to hear from you!

Graduate of an Accredited School of Nursing with an unencumbered RN license Nursing knowledge and skills necessary to treat frail, elderly participants and manage complex clinical situations Highly motivated, self-directed, able to execute tasks in a quickly changing environment, and able to make sound decisions in emergency situations Excellent clinical, organizational, and communication skills in settings with seniors, their families, and interdisciplinary team members Able to work assigned shift which may include days, evenings, nights, weekends, holidays, and overtime

Handle calls (inbound/outbound) as assigned, responding as appropriate within their scope of practice, and consulting with other clinicians, including on-call providers Coordinate telehealth meetings between participants and clinicians Ensure timely care delivery, as well as resolve basic issues, escalating to management as necessary Troubleshoot and effectively resolve logistical care delivery issues relating to aspects such as transportation, medication delivery, and hospital discharge when daytime care teams or responsible central teams are not available Support the clinical care and home health teams to manage smooth care transitions between settings (hospitals, skilled nursing facilities, etc.), escalating changes in participants’ conditions as appropriate

Evry Health

Care Coordination RN - REMOTE

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Primary Care

License:

RN

State License:

Compact / Multi-State

We are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. We strive to ensure members live happier, healthier lives. Evry Health is the major medical division of Globe Life (NYSE:GL). Globe Life has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, Globe Life has earned an A (Excellent) rating or higher from A.M. Best Company.

Evry Health is seeking a tech-savvy Nurse to join our team for Care Coordination. As a Care Coordinator you work with members to improve their wellness and engage with our health plan's benefits. You build good relationships with both our health plan members and our medical providers through phone calls, emails, and texts. This is an exciting role allowing the ability to work with members across the continuum. Our teams are 100% virtual. While this is a remote role, you must reside in the United States and in the Eastern or Central time zone.

You have 1-2 years of experience working at a health plan, preferably with a commercial population. You have 3-5 years of nursing experience in a clinical setting assisting with direct patient care, such as a hospital or ambulatory setting. Must have a current, unrestricted Texas nursing license or Compact License. Please include your license number(s) and the corresponding state(s) in your resume. Diploma from an accredited school/college of nursing required. You have working knowledge of medical and insurance industry terminology including basic understanding of health plan benefits, CPT/ICD10, authorizations, and digital health programs. You have an area of interest or experience within cardiology/pulmonology, women’s health, orthopedic surgery/physical medicine, primary care/pediatrics, and oncology. You have experience outreaching and educating members telephonically. You have an innovative and entrepreneurial spirit with a passion to contribute to a much-needed change in our health care system. Bonus: Familiarity with Salesforce/Healthcloud/CareIQ. Bonus: Experience working in a call center. Bonus: Spanish fluency (conversational). Telecommuting Requirements This is a remote position. Our whole company works remotely. Company headquarters are in Dallas, Texas. Company business hours are weekdays 9-5 CST. We will only consider candidates in the United States who reside in the CST or EST time zones. Required to have a dedicated work area established that is separate from other living areas and provides information privacy. Ability to keep all company sensitive documents secure. Must live in a location that receives an existing high-speed internet connection/service.

Communicate and provide education to members and providers on insurance plan benefits and digital health solutions. Use negotiation and motivational interviewing techniques to increase engagement. Pro-active and reactive support for members, including outbound phone/email/text outreach. Employ active listening & motivational interviewing skills, and can handle difficult calls tactfully, courteously, professionally and document accordingly that can build patient trust and engagement. Ability to effectively excel in a virtual work environment through active participation in team huddles, Supervisor 1:1s, Instant Messaging, or check-ins, efficiently answering and documenting member/provider calls. Accurately track and document work on a variety of internal software tools and platforms. Consult with supervisors, utilization management team, medical directors, as needed to overcome barriers. Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure. Assist departmental staff with coding, medical records/documentation, pre-certification, reimbursement, and claim denials/appeals. Ability to interact with external facility or providers as needed to gather clinical information to support the medical necessity review process and plan of care.

Optum

Remote Complex RN Case Manager, Advantage Plus Network of CT

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Case Management

License:

RN

State License:

Conneticut

Opportunities with Advantage Plus Network of Connecticut, part of the Optum family of businesses. When you work at Advantage Plus Network of Connecticut, your contributions directly sustain the health and well-being of our community. Discover high levels of teamwork, robust medical resources and a deep commitment to exceptional care and service. Join a leading community-based medical group and discover the meaning behind Caring. Connecting. Growing together.

Position Details: Location: Telecommuter position, possible travel to Farmington, CT for training/meetings Department: Case Management Schedule: Full time, 40 hours/weekly, Monday through Friday, 8:00AM - 4:30PM

Physical & Mental Requirements: Ability to lift up to 25 pounds Ability to sit for extended periods of time Ability to stand for extended periods of time Ability to use fine motor skills to operate office equipment and/or machinery Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex problem solving You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Bachelor of Science in Nursing (BSN), or 5+ years case management experience in lieu of BSN Unrestricted current RN licensure in state of Connecticut 2+ years experience in health plan case management, complex and disease case management Experience in a remote and telephonic role Proficient in Microsoft Office and Adobe products Ability to travel to Farmington, Connecticut as necessary for training, meetings, or as requested by supervisor/manager Preferred Qualifications: Master's Degree in Nursing (MSN) Certified Case Manager Certification (CCMC) Case management experience serving community based members residing in Connecticut Experience in discharge planning Experience in utilization review, concurrent review, or risk management A background in managed care Ability to work on a multi-disciplinary team Proven solid critical thinking and decision-making skills Proven excellent interpersonal and communication skills (both written and oral) Bilingual with English and Spanish, Polish, Mandarin, or Vietnamese

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Member Care Coordination Collaborates with physicians and multidisciplinary teams to develop and maintain up to date, coordinated care plans Acts as a liaison between members and the healthcare team to ensure effective communication and alignment of care plans Member Referral Support Assists physicians, members, and families in obtaining referrals to specialists Provides counseling and support tailored to the clinical needs of the member Care Plan Development Creates comprehensive member-centric care plans that include member-driven goals and interventions Partners with designated physicians to create and maintain individualized Member Care Plans Clinical Improvement Actively participates in developing and deploying Coordination of Care activities aimed at enhancing the clinical experience for both referred members and referring physicians Liaison Role Facilitates communication among care team members to address the needs of both the member and the physician Provider/Member Education Provides education to member on health management and maintenance for optimal health outcomes Educates members and care team participants about available community and health plan benefits and services Performs additional tasks as assigned to support the overall goals of the Medical Management department

Optum

Behavioral Health Clinical Program Manager - NEW YORK

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Behavioral Health

License:

RN

State License:

New York

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Clinical Program Manager oversees a remote team of Behavioral Health Care Advocates responsible for utilization management (UM) and case management (CM) of inpatient and outpatient Behavioral Health services. UM is performed via an inbound telephonic queue and requires team members to work a holiday rotation. Case managers work directly with members both telephonically and in the field. The schedule is Monday - Friday, 8a - 5p EST and may include working some holidays. If you are located in New York, you will have the flexibility to work remotely* as you take on some tough challenges.

Required Qualifications: Licensed Clinician in the State of New York with one of the following licensures. Licenses must be active and unrestricted. Licensed Clinical Social Worker (LCSW) Licensed Mental Health Counselor (LMHC) Licensed Psychologist (LP) Registered Nurse (RN) with 5+ years of Behavioral Health experience 6+ years of Behavioral Health experience including Mental Health and Substance Use Disorders (SUD) 5+ years of experience working with Children / Adolescents 3+ years of management experience in a Behavioral Health setting 3+ years of experience with New York public and commercial mental health and substance abuse services delivery system Experience overseeing documentation in Electronic Medical Records (EMR) Experience with Medicare and NY Medicaid regulations Intermediate proficiency in Microsoft Office Suite, including MS Excel Ability to work holidays based on business needs Dedicated, distraction-free workspace and access to high-speed internet in home Residency in New York Preferred Qualifications: Experience working in a Managed Care Organization (MCO) Experience working with the New York provider network Experience managing clinical and non-clinical phone queues Knowledge of evidence-based practices and procedures Solid customer service orientation Familiarity with prior authorizations, concurrent reviews, and appeal processes Familiarity with case management services Demonstrated competence in clinical care management, solid leadership and organization skills, interpretation of State and federal laws, and regulations relevant to the mental health program area

Oversight of utilization management of adults, adolescents and children as well as dual eligible Medicare/Medicaid populations with SMI, SUD, co-occurring physical health, co-occurring disorders of MH and SUD, and co-occurring mental health and/or substance use disorders Manages and is accountable for professional employees and supervisors Sets team direction, resolves problems, and provides guidance to members of team May oversee work activities of other supervisors Adapts departmental plans and priorities to address business and operational challenges Influences or provides input to forecasting and planning activities Oversight of new product implementations Initiating process for state initiatives and directives Updating and creation of Quick Reference Guides Oversight and coordination of care with internal and external partners Experience interfacing with regulatory agencies Interview, hire and onboard new employees Review reports to insure team member adherence to established benchmarks Cover for management team as needed Foster relationship with leadership and medical directors You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Optum

Registered Nurse, Post-Acute Liaison New York Remote

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Case Management

License:

RN

State License:

New York

Optum NY, is seeking a RN Post-Acute Liaison to join our team in Poughkeepsie, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The RN Post-Acute Liaison, in partnership with the Medical Management team and Physician Leadership, will serve as a clinical problem solver to ensure our patients receive care that is safe, high quality, patient-centered, and cost efficient. This includes collaborating with post-acute network facilities, vendors, and Optum partners on complex patient care coordination. If you are located in Poughkeepsie, NY, you will have the flexibility to work remotely* as you take on some tough challenges.

Required Qualifications: Bachelor's Degree or higher in Nursing Unrestricted current NY RN License 2+ years of experience as a nurse case manager 2+ years of experience managing complex disease cases Ability to travel within commutable distance of Poughkeepsie for internal and external on-site meetings 25% of the time Preferred Qualifications: Certified Case Manager 5+ years of experience as a nurse case manager 5+ years of experience managing complex disease cases Experience coordinating patient care in the post-acute setting

Clinical Liaison: Clinical problem solver with facilities, providers, resolution of issues concerning members, benefit interpretation, program definition and clarification Clinical Operations Analysis: Monitors and analyzes medical management activities; provides analytical support to clinical programs; may perform clinical assessments and clinical audits Clinical Program Management: Development, implementation and/or on-going management and administration of a clinical program(s). Provides strategic oversight and support, measurement standards and revisions as needed for delivery of programs focused on quality, affordability and outcomes Communicates with members of the Care Team as appropriate to coordinate the identified Member and physician's needs Provider/Member Education: Educate Member and care team participants on community/health plan benefit services available Performs various duties as needed to successfully fulfill the function of the position in conjunction with Medical Management as needed Identifies solutions to non-standard requests and problems Solves moderately complex problems and/or conducts moderately complex analyses Works with minimal guidance; seeks guidance on only the most complex tasks; Translates concepts into practice Provides explanations and information to others on difficult issues Provides feedback, and guides others Acts as a resource for others with less experience Optum NY/NJ was formed in 2022 by bringing together Riverside Medical Group, CareMount Medical and ProHealth Care. The regional alignment combines resources and services across the care continuum - from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. As a Patient Centered Medical Home, Optum NY/NJ can provide patient-focused medical care to the entire family. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Together, we're making health care work better for everyone. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Medix™

REMOTE UM Appeals Care Manager (RN or LPN) - 253234

Posted on:

May 18, 2026

Job Type:

Contract

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

Medix provides workforce solutions to clients and creates opportunity for talent in the Healthcare, Life Sciences, Engineering and Technology fields. Through our core purpose of positively impacting lives, we have earned our reputation as an industry leader by providing unsurpassed customer service and top quality professionals to our clients.

Utilization Management Nurse (RN/LPN) – Managed Care / Appeals & Authorization (Remote) Overview: We are seeking an experienced and detail-oriented Utilization Management Nurse to support clinical review operations within a fast-paced managed care environment. This role is responsible for conducting medical necessity reviews, processing appeals, coordinating with providers and external review agencies, and ensuring compliance with CMS and state regulatory requirements. The ideal candidate will bring strong clinical judgment, utilization management expertise, and the ability to navigate complex cases while maintaining exceptional documentation standards.

Required: Active, unrestricted RN or LPN license. Minimum 3 years of experience in Utilization Management, Clinical Appeals, Care Coordination, or Discharge Planning. Strong knowledge of CMS Medicaid/Medicare regulations and appeal timelines. Experience using InterQual or MCG criteria for medical necessity and level-of-care determinations. Proficiency with UM and clinical documentation platforms such as HealthEdge, Jiva, or Salesforce Health Cloud. Ability to exercise sound clinical judgment and escalate cases appropriately. Preferred: Certified Case Manager (CCM) or ABQAURP certification. Experience with Medicare Advantage, MLTC, SNP, or other managed care lines of business. Prior experience handling external appeals or regulatory audits involving CMS or DOH. Clinical expertise in Behavioral Health, Oncology, or Complex Surgical Services. Experience conducting internal UM quality audits for NCQA or URAC compliance. Bilingual proficiency strongly preferred. Ideal Candidate: The ideal candidate is highly organized, analytical, and comfortable working in a deadline-driven managed care environment. They possess strong communication skills, exceptional attention to detail, and the ability to collaborate effectively with interdisciplinary teams, providers, and regulatory partners.

Utilization Management Operations: Perform inpatient admission certification, concurrent review, and outpatient/ancillary authorization reviews. Evaluate medical necessity, level of care (LOC), and length of stay (LOS) using InterQual, CMS/Medicare guidelines, and internal medical policies. Ensure all reviews and determinations are completed within required turnaround times (TATs). Appeals & Clinical Review: Review clinical appeals and summarize findings for Physician Advisor or Medical Director review. Coordinate external appeal processes with External Review Agencies (ERA) and Clinical Peer Reviewers. Ensure timely submission of external review documentation and accurate implementation of final determinations. Documentation & Compliance: Maintain accurate and audit-ready documentation within UM and Appeals platforms. Document clinical findings, decision rationales, and review outcomes in accordance with regulatory and accreditation standards. Support compliance with CMS, NCQA, URAC, and state-mandated guidelines. Provider & Member Collaboration: Partner with PCPs and providers to obtain clinical information necessary for case review. Communicate authorization and appeal determinations to providers and members. Educate stakeholders on appropriate treatment alternatives and next steps when applicable. Reporting & Trend Analysis: Analyze pharmacy claims, encounter data, and health risk assessments to identify utilization trends and member needs. Escalate complex or high-risk cases appropriately to Physician Advisors or Medical Directors.

Optum

Telephonic Nurse Practitioner - Massachusetts & New York Licenses Required

Posted on:

May 18, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

NP/APP

State License:

Compact / Multi-State

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together.

The Telehealth Urgent Care program is a comprehensive integrated care delivery program. The National On Call advanced practice clinician (APC) is responsible for providing telephonic/telehealth care and direction to patients, caregivers and facility staff providing 24/7 coverage including holidays. In this remote role you will provide virtual care for patients in various settings. This excellent opportunity affords a collaborative role bringing enormous satisfaction in the care and comfort of our patients. In this role you will have the ability to achieve work life balance. Optum is transforming care delivery with innovative and personal care. As one of the largest employers of APCs, Optum offers unparalleled career development opportunities. Scheduling: This is a Full Time, work from home position requiring various shift coverage with a mix of weekday, weeknights, weekend, and holiday coverage. While shift times can vary, we provide coverage to members 24/7 including all company recognized holidays. Flexibility and the ability to adapt are a must as you will cross cover multiple markets and teams Availability and Coverage expectations for this role 24/7 coverage Position requires a minimum commitment of 40 hours per week Every other weekend coverage between 8-12 hour shifts covering both day and night shifts is required based on business needs Expectations that your are working or have approved PTO for 26 weekends a year. Each FT/PT employee is eligible to have up to 6 weekend shifts a year for PTO Unapproved time away/Unpaid Time Off will result in need to add additional weekend shift to your schedule based on need Holidays are required for all APCs on a rotation basis Holiday scheduling is completed at the beginning of the year for advanced planning. Holiday coverage is provided beginning at 5pm, the end of the last business day, to 8am of the resumption of business hours

Required Qualifications: Education: NP: Graduate of an accredited Master of Science Nursing or Doctor of Nursing Practice program Active and unrestricted license in the state which you reside, as well as State of New York and the State of Massachusetts, and ability to obtain in other required locations. Ability to gain a collaborative practice agreement, if applicable in your state APCs working in jurisdictions that authorize APCs to practice autonomously or without formal supervision must have obtained approval to practice autonomously or without formal supervision from their licensing board, if applicable. New hires who are eligible and have not applied prior to hire date, must apply to practice autonomously or without supervision within 1 month of hire. If not eligible to practice autonomously or without formal supervision at hire, the APC must begin working towards meeting the requirement within 1 month of hire, if applicable, and apply for approval to practice autonomously or without formal supervision within 3 months of becoming eligible Active Nurse Practitioner certification through a national board: NP: Board certified through the American Academy of Nurse Practitioners or the American Nurses Credentialing Center, with certification in one of the following: Family Nurse Practitioner Adult Nurse Practitioner Gerontology Nurse Practitioner Adult-Gerontology Acute Care Nurse Practitioner Current, active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice) Ability to work scheduled shifts in accordance with scheduling policies Proficient computer skills including the ability to document medical information with written and electronic medical records Preferred Qualifications: 3+ years of clinical experience as an APC Active and unrestricted license in the additional states: Connecticut, Rhode Island, New Jersey Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs Experience working in a nursing home, or with seniors in an acute care facility Understanding of Geriatrics, Chronic Illness, and acute disease management Understanding of Advanced Illness and end of life discussions Ability to develop and maintain positive customer relationships Adaptability to change You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Available on provided telephonic platform, both taking and placing calls to coordinate and manage care for members between care givers, facilities, hospitals, primary care providers and the Optum field colleagues Available to use video platform based on clinical need Working hours should be performed in a secure location as patient privacy is required Utilize EMR proficiently to provide acute care to members during all shifts and holiday hours Care Delivery Deliver cost-effective, quality care to members Manage both medical and behavioral, chronic, and acute conditions effectively, and in collaboration with a physician or specialty provider Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations Responsible for ensuring encounter is documented appropriately to support the diagnosis at that visit The APC is responsible for ensuring that all quality elements are addressed and documented Utilizes evidenced based practice guidelines Must attend and complete all mandatory educational and MyLearning training requirements Care Coordination Coordinate care as members transition through different levels of care and care settings Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change Review orders and interventions for appropriateness and response to treatment to identify the most effective plan of care that aligns with the patients' needs and wishes Address and be able to have advanced care plan conversations with members and families Evaluate the plan of care for cost effectiveness while meeting the needs of members, families, and providers to decrease high costs, poor outcomes and unnecessary hospitalizations Program Enhancement Expected Behaviors This is a virtual patient facing role that requires excellent customer service to all parties including members/families, facilities, the entire interdisciplinary care team (PCPs/specialists) and Optum staff Regular and effective communication with internal and external parties including physicians, patients, key decision-makers, nursing facilities, field staff and other provider groups Ability to meet shift scheduling requirements, and attendance expectations Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues Function independently and responsibly with minimal need for supervision Demonstrate initiative in achieving individual, team, and organizational goals and objectives Participate in quality initiatives Availability to check Optum email intermittently for required trainings, communications, and monthly scheduling You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

UnitedHealthcare

Clinical Coordinator RN - Indiana

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Clinical Operations

License:

RN

State License:

Indiana

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

As part of a care management team who will manage complex members, the Care Coordinator will be the primary care manager for a panel of older adult members with a variety of medical and/or behavioral health needs. Care coordination activities will focus on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. Work Schedule: Monday through Friday 8:00 am to 5:00 pm If you reside within the state of Indiana, you will have the flexibility to telecommute* as you take on some tough challenges.

Required Qualifications: Current, unrestricted independent licensure as a Registered Nurse in Indiana 2+ years of experience in long-term support services or working with older adults 1+ years of experience with local behavioral health providers and community support organizations addressing SDoH (e.g., food banks, non-emergent transportation, utility assistance, housing/rapid re-housing assistance, etc.) 1+ years of experience with MS Office, including Word, Excel, and Outlook Ability to travel 75% of the time within assigned territory to meet with members and providers Reside in Indiana Access to reliable transportation & valid US driver's license Preferred Qualifications: Demonstrated experience/additional training or certifications in Motivational Interviewing, Stages of Change, Trauma-Informed Care, Person-Centered Care Experience working in team-based care Experience in serving individuals with co-occurring disorders (both mental health and substance use disorders) Background in Managed Care Bilingual in Spanish or other language specific to market populations Case management experience Physical Requirements: Ability to remain stationary for long periods of time to complete computer or tablet work duties

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the members where they are Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Provide referrals and linkage as appropriate and accepted by member (may include internal consult opportunities such as Housing Navigator, Pharmacy Team, Peer Specialist, etc. or community-based provider referrals such as PCP, specialists, medication assisted therapy referrals, etc.)

UnitedHealthcare

Secondary Review Nurse - Indiana

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Utilization Review

License:

RN

State License:

Indiana

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Secondary Review Nurse plays a critical role in evaluating clinical requests for Home and Community-Based Services (HCBS). This position ensures that care provided is medically necessary, cost-effective, and tailored to the individual needs of each member, while remaining compliant with state regulations. If you reside within the state of Indiana, you will enjoy the flexibility to work remotely * as you take on some tough challenges.

Required Qualifications: Current, unrestricted RN license in the state of Indiana 3+ years of clinical experience in a hospital, acute care, home health / hospice, direct care or case management, able to quickly identify needs and issues 2+ years of experience with completing functional assessments for LTSS services 2+ years of experience with Medicaid, Medicare, or Managed Care and Long Term Services and Supports Intermediate level of knowledge of LTSS experience determining eligibility and appropriate allocation of services Intermediate level of computer/typing proficiency to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications Preferred Qualifications: Pre-authorization experience Utilization Management experience Case Management experience Knowledge of state and federal guidelines Home health or hospice Proven problem-solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action

Participate in secondary reviews for HCBS services and Medicaid services Review and process prior authorization requests for LTSS and HCBS services Apply clinical judgment and decision support tools to determine medical necessity and appropriateness of services Collaborate with care managers, physicians, and other stakeholders to ensure continuity of care and alignment with the members' service plan Monitor utilization patterns and identify opportunities for improved care coordination and cost containment Document all clinical decisions and communications in accordance with regulatory and organizational standards Support quality improvement initiatives and participate in developing education and training for staff Identify potential quality of care concerns, including instances of over/or underutilization of services and escalate these issues as needed Stay current with established guidelines and regulatory requirements You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

UnitedHealthcare

Preservice Review Nurse - PST time zone - Remote

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Utilization Review

License:

RN

State License:

Nevada

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

The Preservice Review RN is responsible for reviewing requests received from providers, using approved protocols and criteria. (Milliman Care Guidelines or Healthcare Operations Protocols). The RN is expected to approve those requests that meet medical necessity, along with benefit level, and the contractual status of the provider / facility as appropriate for self-funded lines of business. This position is also a resource to new staff and may precept as well. Candidates must be available to work Monday - Friday from 8:00 am - 5:00 pm PST. *** You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Required Qualifications: A current, unrestricted RN license for the state of Nevada 2+ years of recent critical care, ER and/or med-surg nursing experience Proficient with Microsoft Word to create, edit, save and send documents Proven ability to navigate a Windows environment, Microsoft Outlook, and conduct Internet searches Preferred Qualifications: 2+ years Utilization Management experience in managed care, acute or rehab setting Knowledge of utilization review process and prior authorization process in a managed health care industry Knowledge of ICD9 / CPT coding and Milliman Care Guidelines Soft Skills: Detail oriented, excellent organizational skills Ability to work well under pressure with sound decision making ability Excellent written and oral communication skills All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Evaluate and assess each request verifying eligibility and specific product Determine benefit level based on site of service Utilize written criteria to approve, pend or send the case to the medical director for review Send cases for pending process when appropriate Maintain at least 98% accuracy of clinical review case notes in Facets Maintain productivity standards and maintain compliance with all regulatory agencies including NCQA, DOL, DOI for each state, Medicaid, CMS and OPM Maintain at least 98% accuracy in summarizing cases for the Medical Director to review using appropriate protocols based members clinical and benefit information Maintain compliance with turnaround times based on the member's product, the type of request and the specific regulatory agency Be knowledgeable of and comply with the Nurse Practice Act for each state that licensure is required to perform SHL business Precepts / act as a resource for new staff You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Optum

RN Care Management Clinical Team Lead - Remote

Posted on:

May 18, 2026

Job Type:

Full-time

Role Type:

Care Management

License:

RN

State License:

California

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Clinical Team Lead will provide operational support to managers and supervisors for the assigned program. The Team lead is an individual contributor. Team lead assignments will be highly dependent on operational needs and priorities. The team leader will work closely with leaders to use data and reporting to identify and prioritize supports needed. They will act as subject matter experts for system and program support. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Prefers Southern California, but candidates could live outside of California if they have a good candidate.

Professional Competencies: Demonstrate knowledge of PC applications including MS Office Suite Ability to use written and oral communication skills Ability to read and interpret data Skill in writing clear, grammatically correct, easy-to-use instructional documentation Ability to identify learning needs, set goals and seek educational opportunities Ability to analyze problems and formulate appropriate plans, solutions and courses of action Knowledge of age specific communication is needed with the ability to listen actively and respond to internal and external customers in a timely, competent manner both verbally and nonverbally Ability to work with frequent interruptions Ability to establish and maintain cooperative working relationships with individuals at all levels of the organization and affiliates Ability to maintain confidentiality of patient and all related entity business matters of the organization and its partners Ability to manage detail and work with accuracy Ability to recognize and act appropriately in situations where patient care needs exceed medical certification Skill in working with a team; ability to collaborate on projects with colleagues Skill in working effectively under deadlines and changing priorities Skills: All staff members are to promote a positive and productive work environment by acting maturely and responsibly, satisfactorily performing his or her job responsibilities and conducting themselves in a professional, courteous, and respectful manner toward fellow employees, physicians and patients Must relate to other people beyond giving and receiving instructions: (a) get along with co-workers or peers without exhibiting behavioral extreme; (b) perform work activities requiring negotiating, instructing, supervising, persuading, or speaking with others; and (c) respond openly and appropriately to feedback regarding performance from a supervisor Integrates Lean principles, practices, and tools to improve operational efficiency, reduce costs and increase customer satisfaction Perform all duties in a manner which promotes and supports the Core Values and Mission Statement Working knowledge of health care delivery systems Work as an interdisciplinary team member with members, physicians, administration, staff and other managers Frequently follow written and oral instructions and complete routine tasks independently Ensures confidentiality of patient information following HIPAA guidelines and company policies Attends/completes training to meet requirements of the job position and as needed or mandated by company policies and regulations Has regular and predictable attendance Required Qualifications: Unrestricted RN license California license 3+ years of broad-based clinical experience and an expert in their respected function Preferred Qualifications: Bachelor's degree BLS if working in a clinical setting

Onboarding new teammates, provide training for the assigned work and monitor quality of work performance during the probationary period In collaboration with the management team will provide ongoing training to teammates identified through quality auditing where opportunities are identified to improve performance or productivity In collaboration with the management will develop and provide training to teams for all new, updated processes and workflows. Training attendance will be documented and submitted with the Operational Support team Manage patient and provider escalations or grievances by providing research into the inquire and provide a summary to the leadership for actions needed Manage health plan escalations in collaboration with the delegation oversight team Development and maintenance of all job aids that support system and processes for the assigned team Support for organizational realignment and change management by providing training, document updates and communication Support resource planning and allocation by reviewing daily assignments, shifting resource assignments when necessary to manage daily workloads Teammate scheduling when applicable Internal messaging and communication on upcoming changes and plans for operational readiness related to membership, programs, regulations or health plan changes Technology training and change readiness monitoring in support of system modifications Post implementation program/process monitoring and re-training to assure quality and performance meet team goals Implementation and monitoring of process changes needed to support CAP remediation in close collaboration with the Delegation oversight team Works with teams to bring forward patients for IDT collaboration Monitors team caseloads and productivity and make recommendations to leadership for workforce management *Note: This job description is not comprehensive of all duties/responsibilities performed. Management retains the right to alter this job description at any time. * The information listed above is not comprehensive of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Precision Financials

Nurses/ NPs Healthcare- Remote Work

Posted on:

May 18, 2026

Job Type:

Role Type:

License:

NP/APP

State License:

Compact / Multi-State

At Precision Financials, we are a team of driven financial professionals dedicated to empowering individuals and families through financial education and leadership. We believe that financial literacy is the cornerstone of true financial independence—and our mission is to equip our clients with the knowledge, tools, and confidence they need to take control of their financial future

Work From Home Opportunity — Ideal for Nurses (RNs, NPs) Founded by an ER RN | Helping People Beyond the Bedside 100% Remote | Work from Anywhere with Wi-Fi Flexible Schedule | Part-Time or Full-Time High Income Potential | Full Training Provided Please Read the Full Description Before Applying Are you a Registered Nurse or Nurse Practitioner who’s passionate about helping people—but seeking a career that offers more freedom, less burnout, and long-term financial stability? You’re not alone. Many healthcare professionals are discovering a new way to serve others—without sacrificing their own health, time, or family life. This opportunity was founded by a career Emergency Room RN who spent years on the frontlines, and now empowers nurses and other purpose-driven professionals to transition from bedside care to financial care.

Basic Qualifications 18 years or older U.S. Social Security Number Able to pass a background check Willing to obtain a state financial license (we support you) Professional, ethical, and strong communication skills

As a licensed Financial Professional, you'll educate families, individuals, and small business owners on how to protect and build wealth through services such as: Life Insurance with Living Benefits Retirement Planning (401k rollovers, indexed accounts, annuities) College Savings Plans Business Protection Strategies You’ll receive full training, licensing support, mentorship, and ongoing professional development—even if you have no prior experience in finance or business.

CVS Health

Case Manager, Registered Nurse

Posted on:

May 18, 2026

Job Type:

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

The Care Manager—Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The Social Worker provides education and guidance to members and their families on managing chronic conditions and navigating the healthcare system. Additionally, the Care Manager develops and implements individualized care plans, monitors member progress, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure optimal health outcomes. Accurate and timely documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies.

Required Qualifications: Candidate must have active and unrestricted Registered Nurse (RN) licensure in the state of Pennsylvania (PA) OR Compact Registered Nurse (RN) licensure in state of residence Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the Care Manager Registered Nurse (RN) role Access to a private, dedicated space to conduct work effectively to meet the requirements of the position Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually 3+ years of nursing experience 2+ years of case management, discharge planning and/or home healthcare coordination experience Preferred Qualifications: Experience providing care management for Medicare and/or Medicaid members. Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health. Experience conducting health-related assessments and facilitating the care planning process. Bilingual skills, especially English-Spanish Education: Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-related field (REQUIRED) Bachelor’s of Science in Nursing (BSN) (PREFERRED) License: Active and unrestricted Registered Nurse (RN) licensure in the state of Pennsylvania (PA) OR Compact Registered Nurse licensure in state of residence

Key Responsibilities: 50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care. Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs. Provides evidence-based disease management education and support to help the member achieve health goals. Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care. Provides care coordination to support a seamless health care experience for the member. Meticulous documentation of care management activity in the member’s electronic health record. Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition. Identifies and connects members with health plan benefits and community resources. Meets regulatory requirements within specified timelines. The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed. Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members. Essential Competencies and Functions: Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements of this role. Conduct oneself with integrity, professionalism, and self-direction. Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. Familiarity with community resources and services. Ability to navigate and utilize various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records. Maintain strong collaborative and professional relationships with members and colleagues. Communicate effectively, both verbally and in writing. Excellent customer service and engagement skills.

CVS Health

Telehealth Nurse Case Manager

Posted on:

May 18, 2026

Job Type:

Role Type:

Telehealth

License:

RN

State License:

Texas

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Candidate must reside in a compact state As a Nurse Case Manager, you will play a crucial role in providing healthcare support, care coordination and/or case management to members enrolled in a comprehensive healthcare program. Your expertise in nursing and healthcare management will be instrumental in assessing individuals' health needs, providing education and resources, and empowering them to make informed decisions about their health following a hospitalization, Emergency Department discharge, and/or a change to a higher level of acuity. SCOPE: Concierge Clinical Ops Case Managers, Triage Case Managers WORK SCHEDULE: This is a Monday thru Friday work schedule: 8 am to 5 pm your time zone with on flex day per week, 12 pm to 9 pm OR split flex 9 am to 1 pm and 5 pm to 9 pm your time zone.

Education: RN Diploma, Associates or Bachelor’s in nursing REQUIRED SKILLS: Registered Nurse (RN) licensure with a minimum of 3 years of clinical experience. Aptitude for computer skills, proficiency with Microsoft and web-based applications. Experience in health management, care coordination, or telephonic nursing is preferred. Strong clinical knowledge and understanding of chronic diseases, preventive care, and health promotion. Excellent communication and interpersonal skills, with the ability to engage individuals over the phone and build rapport. Demonstrate utmost level of professionalism in all work interactions Empathetic and patient-centered approach to care, with a focus on empowering individuals to take control of their health. Ability to understand and explain complex medical information in a clear and understandable manner. Strong organizational and time management skills, with the ability to prioritize tasks and manage a caseload effectively. Proficiency in using telehealth platforms and digital technology for individualized member monitoring which may include toggling between multiple applications during member calls Ability to handle both inbound and outbound calls providing timely and accurate nursing support and guidance as needed. Ability to multitask while working independently and collaboratively in a remote and fast-paced environment. Commitment to ongoing professional development and staying updated on the latest healthcare trends and guidelines. Certified Case Manager Certification, CCM, strongly preferred. If candidate does not currently hold certification, they must obtain within 4 years of employment. A Registered nurse must hold an unrestricted license in their state of residence, with multi-state compact privileges and have the ability to be licensed in all non-compact states, territories and the District of Columbia based on the needs of the business. Preferred Qualifications: Certified Case Manager Certification is a plus Previous telephonic/telehealth experience in health care Epic software experience

Clinical Assessments: Conduct comprehensive health assessments of members enrolled in healthcare programs through telephonic and/or digital tool interactions. Gather relevant medical, social, and lifestyle information to develop a holistic understanding of each member’s current status. Identify potential key risks, gaps in care, and opportunities for enhancing well-being. Education and Coaching: Provide telephonic and/or digital education, nursing interventions, and coaching to members on various health topics, including chronic disease management, preventive care, and healthy lifestyle choices. Empower members to take an active role in managing their health by providing them with the knowledge and tools needed. Collaborate with members to set achievable health goals and develop personalized action plans. Care Coordination and Referrals: Coordinate with healthcare providers and community resources to facilitate access to necessary services and support. Facilitate referrals to internal multidisciplinary care team members including Health Management Nurses and Resource Specialists. Assist members in navigating the healthcare system, including understanding insurance coverage and finding appropriate providers and resources. Health Monitoring and Follow-up Regularly monitor individuals' health status and progress towards their health goals through telephonic and/or digital tool check-ins. Provide ongoing support, encouragement, and accountability to individuals to help them stay on track with their health management plans. Collaborate with healthcare providers to ensure continuity of care and timely interventions when necessary. Documentation Reporting Maintain accurate and up-to-date documentation of telephonic and/or digital tool interactions, assessments, care plans, and outcomes. Ensure compliance with privacy and confidentiality regulations, including HIPAA guidelines. Ensure adherence to quality benchmarks and standards in all documentation, maintaining accuracy, clarity, and compliance with organizational guidelines. Demonstrate timely completion of case management activities in alignment with organizational protocols and NCQA accreditation standards, including documentation, care planning, and follow-up within required timeframes. Perform additional duties as assigned based on the evolving needs of the business.

Dane Street

(RN / NP/ PAs) for Disability Case Reviews - Remote Opportunity

Posted on:

May 18, 2026

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Compact / Multi-State

Dane Street is the industry's fastest growing national IME and Peer Review provider with a panel of board-certified, active-practice physicians in all 50 states. Services are provided to the Workers Compensation, Pharmacy, Disability, Group Health and Auto/Liability lines of business. Dane Street's Review and Evaluation services provide improved report quality, faster turnaround time and higher adjuster/nurse satisfaction and productivity.

Dane Street is seeking experienced Registered Nurses (RNs); or Nurse Practitioner (NP) ; or Practicing Assistants (PAs) to support our disability case review process. In this role, you will perform clinical reviews of disability claims, providing essential support to our decision-making team. These reviews will follow a structure similar to those performed by MDs, but are specifically designated for RN-level review. THIS IS PRN ONLY Previous experience in disability peer reviews required

Active, unrestricted RN; NP or PA license (multi-state preferred) Experience with Evidence of Insurability (EOI) Previous experience in disability reviews required Strong attention to detail and critical thinking skills Excellent written and verbal communication Comfortable working independently in a remote setting Experience with insurance or occupational health is a plus

Conduct thorough clinical reviews of disability claims Analyze medical records for accuracy and completeness Apply clinical expertise to evaluate claim validity Follow established review protocols and documentation standards

CVS Health

Case Manager Registered Nurse (Work from Home - New York License)

Posted on:

May 18, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

New York

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

*Must possess RN NY license** The Care Manager—Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The Social Worker provides education and guidance to members and their families on managing chronic conditions and navigating the healthcare system. Additionally, the Care Manager develops and implements individualized care plans, monitors member progress, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure optimal health outcomes. Accurate and timely documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies.

Required Qualifications: Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the CM RN role. Access to a private, dedicated space to conduct work effectively to meet The requirements of the position. Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually. Minimum 3+ years of nursing experience Minimum 2+ years of case management, discharge planning and/or home healthcare coordination experience Preferred Qualifications: Experience providing care management for Medicare and/or Medicaid members. Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health. Experience conducting health-related assessments and facilitating the care planning process. Bilingual skills, especially English-Spanish Education: Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-related field (REQUIRED) Bachelor’s of Science in Nursing (BSN) (PREFERRED) License: Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY

50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care. Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs. Provides evidence-based disease management education and support to help the member achieve health goals. Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care. Provides care coordination to support a seamless health care experience for the member. Meticulous documentation of care management activity in the member’s electronic health record. Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition. Identifies and connects members with health plan benefits and community resources. Meets regulatory requirements within specified timelines. The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed. Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members. Essential Competencies and Functions: Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements of this role. Conduct oneself with integrity, professionalism, and self-direction. Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. Familiarity with community resources and services. Ability to navigate and utilize various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records. Maintain strong collaborative and professional relationships with members and colleagues. Communicate effectively, both verbally and in writing. Excellent customer service and engagement skills.

Phaxis

MLTC UM RN

Posted on:

May 18, 2026

Job Type:

Full-Time

Role Type:

Utilization Review

License:

RN

State License:

New York

Phaxis is one of the nation's leading recruiting and consulting firms. Working directly with our clients, candidates and consultants, our team is focused on bringing the right people together. Despite working nationally, we never forget our local roots. Whether it’s recruiting for technology, travel healthcare, allied or local healthcare, finance & accounting, or support services, legal or marketing, our team understands how to deliver results. Since 2002, we have been dedicated to tailoring our approach to both our client’s and candidate’s unique journey.

Remote RN Utilization Management Nurse (MLTC) Remote | NY RN License Required $62/hour We are seeking an experienced Registered Nurse (RN) with MLTC experience for a Remote Utilization Management role with a leading healthcare organization.

Active NY RN License MLTC experience required Utilization Review / Case Management experience preferred Strong clinical assessment and documentation skills Weekend rotation required

Review clinical records and evaluate requests for medical services Perform prior authorization and concurrent reviews Determine medical necessity and appropriate level of care Collaborate with providers, care managers, and interdisciplinary teams Ensure compliance with state and federal regulations

Nsight Health

Remote Patient Monitoring - Bilingual LVN

Posted on:

May 18, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

LPN/LVN

State License:

Compact / Multi-State

Nsight Health is transforming how care is delivered through Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and Behavioral Health Integration (BHI). We empower healthcare providers to manage chronic conditions using real-time data, AI-enabled technology, and 24/7 clinical support. Our HIPAA-compliant platform connects patients and care teams nationwide—improving outcomes, adherence, and peace of mind. Join a fast-growing, mission-driven team that blends healthcare and technology to make a measurable difference in people’s lives. Nsight Health — Where Technology Meets Compassion.

We are seeking a motivated and detail-oriented LVN/LPN to join our Remote Patient Monitoring Department. In this role, you will be responsible for supporting patients with real-time health monitoring, respond to alerts and deliver timely life-improving interventions, and educate and empower patients through ongoing care.

Required: Active LVN/LPN license required Proficient with computers, EMRs, and telehealth tools Strong communication and organizational skills Bilingual Proficiency: Fluent in English and Spanish Preferred: At least 1 year of nursing experience preferred (RPM, telehealth, or chronic care experience is a plus) Work From Home Requirements Minimum internet speed of 50 Mbps download / 10 Mbps upload Hardwired internet connection required Speed test submission required during the offer process Private, HIPAA-compliant workspace Schedule This position operates on a 4-day work week structure, consisting of 10-hour shifts. Must be available to work rotating holidays throughout the year. Requires mandatory coverage of a minimum of two (2) weekends per month. Training Requirements All new hires must complete a comprehensive training program: Duration: Five weeks Schedule: Monday through Friday, 9:00 AM – 6:00 PM Eastern Time Attendance is mandatory to ensure readiness prior to independently supporting patients. Compensation & Benefits Competitive base pay of $24-$26 per hour. Shift Differentials: Evening Differential: +$1.50/hour for hours worked after 7:00 PM ET Late-Night Differential: +$2.00/hour for hours worked after 10:00 PM ET Weekend Differential: +$1.50/hour for all hours worked Saturday and Sunday Shift differentials are paid in addition to base hourly wages and reflected in the applicable payroll cycle.

Conduct outbound phone calls to check in on patients and address health concerns (expected call volume ranges from 70 to 90 calls per day) Handle inbound phone calls and route appropriately based on clinical urgency Route non-clinical inbound calls to the appropriate departments across the company Monitor and respond to Remote Patient Monitoring (RPM) alerts, escalating concerns when clinically indicated Collaborate with providers to coordinate timely and effective patient care Perform monthly wellness assessments and complete comprehensive chart reviews Accurately document all patient interactions in our clinical platform in real time Consistently meet or exceed individual and team performance metrics related to care quality, patient engagement, response times, and adherence to protocol standards Maintain compliance with company policies and applicable regulations Perform other duties as assigned