Clinical Investigator Oscar HealthClinical InvestigatorNew York, NYRemote$75,348–$98,894 / yearBachelor of Science in Nursing (BSN), Associate Degree in Nursing (ADN) with a Bachelor of Science in Health Administration, Clinical Informatics, or a related Medical Science field, or Associate Degree in Nursing (ADN) with 5+ years of specialized clinical audit experience. Work Location: This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia.
Remote Registered Nurse (RN) Case Manager ValerisRemote Registered Nurse (RN) Case ManagerDanbury, ConnecticutRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. calling and working with the patient’s insurance payer to determine coverage benefits, anticipated out-of-pocket costs associated with their therapy and resources for financial assistance, where applicable based upon needs communicated by the patient.
Complex Oncology Nurse Navigator (11:30AM - 8:00PM EST) Thyme Care IncComplex Oncology Nurse Navigator (11:30AM - 8:00PM EST)NYRemoteToday, Thyme Care is a market-leading value-based oncology care enabler, partnering with national and regional health plans, providers, and employers to deliver better outcomes and lower costs for thousands of people across the country. In it, you will conduct clinical assessments, monitor for changes in health, coordinate care, including transitions, and educate members and caregivers about their diagnosis and treatment over the phone to support our higher-acuity members as they move through the oncology care continuum.
Oncology Transitions of Care Nurse (11:30AM - 8:00PM EST) Thyme Care IncOncology Transitions of Care Nurse (11:30AM - 8:00PM EST)NYRemoteToday, Thyme Care is a market-leading value-based oncology care enabler, partnering with national and regional health plans, providers, and employers to deliver better outcomes and lower costs for thousands of people across the country. In it, you will conduct clinical assessments, monitor for changes in health, coordinate care, including transitions, and educate members and caregivers about their diagnosis and treatment over the phone to support our members as they move through the oncology care continuum.
Registered Nurse Patient Care Manager American Oncology Network IncRegistered Nurse Patient Care ManagerNYRemote$52,395.20–$92,164.80 / yearProvides disease specific management, a working knowledge of oncology principles, the ability to manage chemotherapy and the side effects, and can monitor and address symptoms. Ensure patient has all information to make informed decisions regarding treatment, understands the role of Care Management, and how to access services appropriately.
Registered Nurse - Fully Remote MercorRegistered Nurse - Fully RemoteNew York, New YorkRemote$55–$65 / hourExperience reviewing charts for quality improvement, utilization review, CDI, or clinical informatics. For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome.
NewRN Health Care Facility Surveyor Impact Recruiting SolutionsRN Health Care Facility SurveyorNew York, New YorkRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking an RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
Senior Manager, Patient Access Advocate, West Revolution Medicines IncSenior Manager, Patient Access Advocate, WestNYRemote$187,200–$208,000 / yearBy acting as a single point of contact, the RNCM will proactively manage and work individual patient cases to ensure access and financial barriers are compliantly overcome -including benefit verifications, Prior Authorization (PA) delays, denials, appeals hurdles, specialty pharmacy (SP) and non-commercial pharmacy routing issues, affordability barriers, complex Center for Medicare and Medicaid cases (CMS), community resources and more. RNCMs will work directly with patients, healthcare providers, insurers, field reimbursement team, and other key stakeholders to help patients understand their coverage, access the company's patient support programs, and connect with external resources that help overcome access barriers.
Senior Manager, Patient Access Advocate, East Revolution Medicines IncSenior Manager, Patient Access Advocate, EastNYRemote$187,200–$208,000 / yearBy acting as a single point of contact, the RNCM will proactively manage and work individual patient cases to ensure access and financial barriers are compliantly overcome -including benefit verifications, Prior Authorization (PA) delays, denials, appeals hurdles, specialty pharmacy (SP) and non-commercial pharmacy routing issues, affordability barriers, complex Center for Medicare and Medicaid cases (CMS), community resources and more. RNCMs will work directly with patients, healthcare providers, insurers, field reimbursement team, and other key stakeholders to help patients understand their coverage, access the company's patient support programs, and connect with external resources that help overcome access barriers.
NewRN Infusion - Transition Associate (Travel) American Oncology Network IncRN Infusion - Transition Associate (Travel)NYRemote$29.52–$42.39 / hourAbility to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations. Telephone triage: Includes prioritizing incoming calls and messages from patients, family members, hospitals, nursing facilities, pharmacies and physician offices from emergent to non-urgent.
Remote Nurse Practitioner, Palliative Care at Home - Mount Sinai Home Health - Full Time - Day Mount Sinai Health SystemRemote Nurse Practitioner, Palliative Care at Home - Mount Sinai Home Health - Full Time - DayNew York, NYRemote$123,576–$197,400 / yearWe are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. The team works in collaboration with patients' healthcare teams to provide high quality evidence based complex palliative care and chronic care management and is designed to improve symptoms and QOL, reduce caregiver burden, reduce unnecessary inpatient utilization, and facilitate hospice when appropriate.
Clinical Review & Correspondence RN Cohere Health Technologies LLCClinical Review & Correspondence RNNYRemote$31–$35 / hourBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. Opportunity Overview: The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical determinations, and ensuring accurate member and provider communications.
Clinical Clearance Specialist RN Charlie Health IncClinical Clearance Specialist RNNYRemote$48–$52 / hourThis RN serves as the dedicated clinical reviewer for escalated admissions cases involving eating disorder (ED) and substance use disorder (SUD) presentations - cases that require nursing-level clinical expertise beyond the independent decision-making scope of the CAT team, but that do not require physician review. You will own the clearance review queue, interpret labs, vitals, and EKGs, issue timely admission determinations, and serve as the primary clinical bridge between the admissions team and medical leadership.
Clinical Clearance Specialist (RN) Charlie HealthClinical Clearance Specialist (RN)New York, NYRemote$48–$52 / hourThis RN serves as the dedicated clinical reviewer for escalated admissions cases involving eating disorder (ED) and substance use disorder (SUD) presentations — cases that require nursing-level clinical expertise beyond the independent decision-making scope of the CAT team, but that do not require physician review. You will own the clearance review queue, interpret labs, vitals, and EKGs, issue timely admission determinations, and serve as the primary clinical bridge between the admissions team and medical leadership.
Pediatric Triage RN - Overnight 9pm - 9am ET Pomelo Care IncPediatric Triage RN - Overnight 9pm - 9am ETNYRemote$78,000–$83,000 / yearWith the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information. Reporting to a Nurse Lead, your key responsibilities will include: Assessment of urgent pediatric concerns and proactively triaging patients to support appropriate utilization of Pomelo Care and/or emergency services.
Remote Care Manager, LTSS (RN) NEW YORK Molina Healthcare IncRemote Care Manager, LTSS (RN) NEW YORKLong Island, NYRemoteAt least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
NewDirector of Compliance (Remote) Ennoble CareDirector of Compliance (Remote)Hackensack, NJRemoteEnnoble Care offers a variety of programs including, remote patient monitoring, behavioral health management, and chronic care management, to ensure that our patients receive the highest quality of care by a team they know and trust. Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in New York, New Jersey, Maryland, DC, Virginia, Oklahoma, Kansas, Pennsylvania, Texas, Florida, and Georgia.
Advanced Practice Nurse - Fully Remote MercorAdvanced Practice Nurse - Fully RemoteNew York, New YorkRemote$70–$110 / hour4+ years of experience as a Nurse Practitioner (NP), Advanced Practice Registered Nurse (APRN), Family Nurse Practitioner (FNP), Acute Care Nurse Practitioner (ACNP), Pediatric Nurse Practitioner (PNP), or another closely related advanced practice nursing role. Experts who complete their first task within the required timeline will then be qualified to be paid hourly for the remainder of the project.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorNew York, NYRemote$75,000–$90,000 / yearThe Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
Clinical Validation Audit (CVA) Trainer ExlService Holdings IncClinical Validation Audit (CVA) TrainerNYRemote$85,000–$110,000 / yearThis role partners closely with Clinical Auditors, Quality Analysts, and Subject Matter Experts to ensure training content reflects current coding guidelines, clinical validation requirements, and audit expectations. The CVA Trainer plays a critical role in improving audit consistency, accuracy, and completeness by translating audit outcomes into effective learning experiences.