Case Manager, Registered Nurse — 50 Locations. Apply via Workday.
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Case Manager, Registered Nurse (Oncology experience required) — 50 Locations. Apply via Workday.
Opportunity Overview: The Sr. Director, GIC India Clinical Operations is a foundational leadership role responsible for establishing, scaling, and managing the clinical RN review function within Cohere Health's Global Innovation Center (GIC) in Hyderabad, India. This leader will build a high-performing team of US NCLEX-certified Registered Nurses (NCLEX-RNs) who perform prospective, concurrent, and retrospective clinical reviews for prior authorization cases on behalf of Cohere Health's US payer clients. The Sr. Director will be accountable for the end-to-end clinical operations delivery from the India GIC, ensuring that RN reviewers assess medical records and clinical documentation for appropriateness and medical necessity in strict alignment with clinical guidelines (including MCG Care Guidelines), Cohere Health internal criteria, National and Local Coverage Determinations (NCD/LCD), and regulatory standards (CMS, NCQA, HIPAA, HITRUST). This role operates within Cohere Health's push-pull delivery framework, where the US retains program ownership, process design, client relationships, and final clinical determination authority, while the India GIC executes clinical review operations per established SOPs and work instructions. This is a highly strategic role requiring a leader who can bridge US healthcare clinical operations with India-based talent delivery, foster a culture of clinical excellence, and drive continuous quality improvement in a fast-paced, technology-driven environment. What you’ll do: Clinical Operations Setup & Strategy Lead the end-to-end setup and operationalization of the clinical RN review function at the Hyderabad GIC, including infrastructure, workflows, staffing models, and technology enablement via Cohere Unify™ Design and implement a scalable operating model for clinical prior authorization reviews across multiple delegated specialties (e.g., musculoskeletal, cardiology, radiology, diagnostic imaging) served by Cohere Health'
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. In collaboration with Medical Directors and cross-functional partners, this role ensures that clinical decisions are evidence-based, align with regulatory and accreditation standards, and are communicated effectively and timely. Through precise clinical review and documentation, you will help support high-quality care, regulatory compliance, and improved member outcomes. What you’ll do: Consult with Medical Directors on clinical determinations, medical necessity decisions, and related clinical correspondence Prepare clear, accurate, and compliant member and provider communications in alignment with regulatory and organizational requirements Understand regulatory requirements governing utilization management decisions and ensure appropriate application to clinical determinations and communications Understand when and why member and provider notifications are required, including regulatory and clinical triggers for written communication Support verbal notification workflows when timely communication of clinical determinations is required Document clinical information completely, accurately, and in a timely manner Consistently meet or exceed productivity, quality, and turnaround time expectations Maintain a thorough understanding of accreditation and regulatory requirements and ensure utilization management decision-making and timeliness standards remain in compliance Perform other duties as assigned What you’ll need: Registered Nurse with active, unencumbered license in the state of residence Experience developing member and provider correspondence within a health plan environment Minimum of 3 years of clinical experience Utilization Management experience required Knowledge of
Opportunity Overview: The RN Reviewer position is a crucial role in our organization — in this role you are responsible for performing a full range of activities that will positively impact the organization and contribute to guiding the strategic operations for the company. As an RN Reviewer, you will perform prospective review (prior authorization) admission, concurrent, and retrospective reviews according to established criteria and protocols to determine the medical appropriateness of the clinical requests from providers. You will work closely with Medical Directors and other Cohere Health staff to ensure appropriate cost-effective care by applying your clinical knowledge and critical thinking skills to assess the medical necessity of inpatient admissions, outpatient services and procedures, and provider out of network requests. You will be required to review Commercial, Medicare, and Medicaid lines of business. You will need to be an agile and comprehensive thinker and planner and be able to work in an environment that is in flux. This position offers the ability to make a substantive mark in simplifying the way healthcare is delivered and contributes to an up and coming company with exponential growth opportunity. What you'll do: Review medical necessity for inpatient, concurrent, prior auth, and retrospective cases to ensure appropriate, high-quality care Collaborate with Medical Directors and providers to align on clinical decisions Document reviews accurately and meet production/quality goals Apply MCG, Cohere, and coverage guidelines to ensure compliance and consistency Partner across teams (Operations, Product, Quality, Health Plans) to improve processes and outcomes Identify opportunities for care management or quality improvement programs Support accreditation, regulatory, and quality initiatives What you'll need: Strong communication and collaboration skills across remote teams Customer-focused mindset and ability to stay calm under pressure
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 Fully remote role with requirement to reside in the Northwest/Mountain area (ID, MT, NV, OR, UT, WA, WY) and be a Registered Nurse (RN) licensed in the state of residence. Travel up to 25% possible in support of Value Based Care groups. Schedule is Monday - Friday 8am to 5pm. No nights, no weekends and no holidays. The Senior Clinical Strategist works with assigned Aetna Medicare Provider Collaboration groups to drive improved performance by leading clinical performance improvement projects and managing multiple complex deliverables through to implementation. Projects will support population health and will primarily impact Stars and quality but will also focus on improvements in utilization and cost. The Senior Clinical Strategist works to drive clinical performance of assigned Medicare Provider Collaboration groups by: - Establishing trusting relationships with provider partners to promote open communication - Serving as clinical expert on actionable opportunities related to CM, gap closure, workflow discussions, and partnering with case manager supervisor/manager and CMs - Serving as internal and external liaison and clinical resource, interpreting data and educating regarding how to utilize data for PC performance improvement -Strategizing with SMEs and clinical teams both internally and externally to drive outcomes and i
Job Title: Theatre Nurses (Anaesthetics & Scrub) – Nottingham Banding: Band 5 Location: Nottingham Rate: £18.00 - £25.60 per hour As a Theatre Nurse in Anaesthetics , Recovery , or Scrub , you will be responsible for providing expert care to patients undergoing surgical procedures. You will work as part of a multidisciplinary theatre team to ensure a smooth and safe surgical experience, from pre-operative preparation through to post-operative recovery. You will be involved in monitoring patients during anaesthesia, assisting in scrubbing for procedures, ensuring sterile environments, and supporting patients during recovery. Your role will be vital in supporting patients’ safety, comfort, and well-being throughout their surgical journey. Key Responsibilities: Anaesthetics: Assist with pre-operative assessments, support anaesthetists during induction and maintenance of anaesthesia, and monitor patients’ vital signs during surgery. Scrub: Prepare sterile equipment and instruments, assist surgeons during procedures, and ensure the surgical field is maintained sterile throughout the operation. Recovery: Monitor and support patients as they wake from anaesthesia, manage pain relief, and assess for any post-operative complications. Work as part of a collaborative theatre team to ensure high standards of patient care and safety Provide emotional support to patients pre- and post-surgery, reassuring them and their families Ensure the environment adheres to the highest infection control and safety standards Exclusive Benefits: Weekly Pay: Enjoy weekly pay, so you don’t have to wait for your earnings. £500 Refer a Friend Scheme: Refer a colleague or friend and earn a £500 bonus. Dedicated Consultant Support: Receive personal support from a Pulse Nursing consultant who understands your career aspirations and can help you achieve your professional goals. Access to a Wide Range of Roles: Work across different healthcare settings and gain experience in various thea
CHEMOTHERAPY Nurse (Band 5 & Band 6) – COVENTRY Pulse Nursing is seeking skilled and experienced Chemotherapy nurses to join our team. As a Chemotherapy nurse, you’ll thrive in a fast-paced environment, working alongside healthcare professionals to deliver exceptional patient care. This role is incredibly fulfilling, allowing you to enhance your clinical skills while positively impacting the lives of patients who rely on your dedicated care. Pulse also offers a range of benefits to support your professional growth. In this current opportunity, you’ll enjoy the flexibility to plan by booking shifts in advance, giving you greater control over your schedule. We offer various shift patterns, including full-time equivalent hours, in Coventry with competitive pay ranging from £28.60 to £35.60 per hour. Requirements: NMC Registration. Minimum of 6 months of recent experience in Chemotherapy within the last 12 months. The ability to provide two professional references covering the previous 3 years of work. Compliance with framework requirements, including DBS check and Occupational Health clearance. Proof of the right to work in the UK. Benefits: Weekly Pay: Receive your salary weekly. Holiday Pay: Available for PAYE workers. Payment Options: Choose from PAYE, PSC/LTD, or umbrella payment methods. Shift Management App: Access our online app to view and book shifts 24/7. Training and Development: Benefit from additional voluntary, high-quality training. Free uniforms are provided for all staff. Recommend a Friend Scheme: Earn up to £500 per referral. If you’re a dedicated Chemotherapy nurse looking for an exciting opportunity, we’d love to hear from you.
We’re now exclusively working with an specialist Neurodevelopmental assessment service who ae looking to hire NMP Registered Nurses on a permanent contracts, due to on-going demand and clear signs of continued growth. Full time and part time applicants will be considered (minimum 2-3 days a week), salary paying between £55k - £65k. This role is a mix of remote working and working on site in Hampshire. Requirements • Professional experience in the field, including dealing with crisis situations. • Qualified Mental Health Nurse from an accredited institution, holding an independent non-medical prescribing qualification (V300). • Registered with the NMC, and maintenance of validation. • Specialisation or experience in the assessment and treatment of ADHD. • Excellent communication and interpersonal skills. • Ability to work both independently and collaboratively, including within a multidisciplinary team. • Maintaining compliance as per company regulations i.e., evidence of current registration with NMC and appropriate professional body.
Pulse Nursing are currently seeking Band 5 & 6 A&E Nurses to join our growing team to work for Barts Health NHS Trust. Barts Health NHS Trust currently have a high volume of shifts available and as a Pulse healthcare professional, you get the first choice of the best shifts! This current opportunity will give you the flexibility to book in advance so you can plan ahead and in turn, be in control of your schedule. With Barts being one of Pulse Nursing’s priority clients, we can offer a great deal of shifts within this trust. We are offering a variety of shift patterns, including the option of full-time equivalent hours, in Barts Health Trust paying between £19.72 - £38.23 per hour. As a Band 5 or 6 A&E Nurse, you will be at the frontline of emergency care, providing high-quality treatment to patients with a range of acute medical conditions. Working within a multidisciplinary team, you will be exposed to a variety of clinical situations, from minor injuries to major trauma, ensuring every day is different and challenging. Key Responsibilities: Deliver high-quality, patient-centered care in a busy and varied emergency department setting. Triage patients efficiently, assess their needs, and prioritize care based on clinical urgency. Administer medications, treatments, and emergency interventions as required. Communicate effectively with patients, families, and colleagues to ensure coordinated and safe care. Collaborate with the wider healthcare team to ensure smooth patient flow and continuity of care. Role Requirements: Registered Nurse (RN) with a valid NMC registration Passionate about emergency care and committed to delivering high standards of nursing. Minimum of 6 months experience in a clinical setting To meet our framework compliance requirements including DBS, Occupational Health, Clinical References and Updated CV Right to work within the UK – Proof will be required. In return Pulse Nursing will offer you the following benefits: Weekly
Pulse Nursing are currently seeking Band 5 & 6 A&E Nurses to join our growing team to work for Barts Health NHS Trust. Barts Health NHS Trust currently have a high volume of shifts available and as a Pulse healthcare professional, you get the first choice of the best shifts! This current opportunity will give you the flexibility to book in advance so you can plan ahead and in turn, be in control of your schedule. With Barts being one of Pulse Nursing’s priority clients, we can offer a great deal of shifts within this trust. We are offering a variety of shift patterns, including the option of full-time equivalent hours, in Barts Health Trust paying between £19.72 - £38.23 per hour. As a Band 5 or 6 A&E Nurse, you will be at the frontline of emergency care, providing high-quality treatment to patients with a range of acute medical conditions. Working within a multidisciplinary team, you will be exposed to a variety of clinical situations, from minor injuries to major trauma, ensuring every day is different and challenging. Key Responsibilities: Deliver high-quality, patient-centered care in a busy and varied emergency department setting. Triage patients efficiently, assess their needs, and prioritize care based on clinical urgency. Administer medications, treatments, and emergency interventions as required. Communicate effectively with patients, families, and colleagues to ensure coordinated and safe care. Collaborate with the wider healthcare team to ensure smooth patient flow and continuity of care. Role Requirements: Registered Nurse (RN) with a valid NMC registration Passionate about emergency care and committed to delivering high standards of nursing. Minimum of 6 months experience in a clinical setting To meet our framework compliance requirements including DBS, Occupational Health, Clinical References and Updated CV Right to work within the UK – Proof will be required. In return Pulse Nursing will offer you the following benefits: Weekly
Pulse Nursing are currently seeking Band 5 & 6 Registered Neonatal Nurses to join our growing team to work for Barts Health NHS Trust. Barts Health NHS Trust currently have a high volume of shifts available and as a Pulse healthcare professional, you get the first choice of the best shifts! This current opportunity will give you the flexibility to book in advance so you can plan ahead and in turn, be in control of your schedule. With Barts being one of Pulse Nursing’s priority clients, we can offer a great deal of shifts within this trust. We are offering a variety of shift patterns, including the option of full-time equivalent hours, in Barts Health Trust paying between £20.89 - £39.58 per hour. As a Band 5 Neonatal Nurse, you will provide high-quality care to premature and sick newborns in the Neonatal Unit. Working alongside a multidisciplinary team, you will use your expertise to deliver specialist care, support families, and ensure the best possible outcomes for your tiniest patients. Key Responsibilities: Provide holistic, family-centered care to premature and critically ill newborns. Assess, plan, implement, and evaluate individualized nursing care plans. Administer medications, treatments, and life-support care in line with neonatal protocols. Support parents and families, providing education, emotional support, and guidance. Work collaboratively with a multidisciplinary team, including neonatologists, paediatricians, and allied health professionals. Role Requirements: Registered Nurse (RN) with a valid NMC registration Completed Neonatal Intensive Care (NICU) training. Passionate about neonatal care and committed to providing high-quality, compassionate nursing. Minimum of 6 months experience in a clinical setting To meet our framework compliance requirements including DBS, Occupational Health, Clinical References and Updated CV Right to work within the UK – Proof will be required. In return Pulse Nursing will offer you the following benefits: Wee
Pulse Nursing are currently seeking Band 5 & 6 Registered Neonatal Nurses to join our growing team to work for Barts Health NHS Trust. Barts Health NHS Trust currently have a high volume of shifts available and as a Pulse healthcare professional, you get the first choice of the best shifts! This current opportunity will give you the flexibility to book in advance so you can plan ahead and in turn, be in control of your schedule. With Barts being one of Pulse Nursing’s priority clients, we can offer a great deal of shifts within this trust. We are offering a variety of shift patterns, including the option of full-time equivalent hours, in Barts Health Trust paying between £20.89 - £39.58 per hour. As a Band 5 Neonatal Nurse, you will provide high-quality care to premature and sick newborns in the Neonatal Unit. Working alongside a multidisciplinary team, you will use your expertise to deliver specialist care, support families, and ensure the best possible outcomes for your tiniest patients. Key Responsibilities: Provide holistic, family-centered care to premature and critically ill newborns. Assess, plan, implement, and evaluate individualized nursing care plans. Administer medications, treatments, and life-support care in line with neonatal protocols. Support parents and families, providing education, emotional support, and guidance. Work collaboratively with a multidisciplinary team, including neonatologists, paediatricians, and allied health professionals. Role Requirements: Registered Nurse (RN) with a valid NMC registration Completed Neonatal Intensive Care (NICU) training. Passionate about neonatal care and committed to providing high-quality, compassionate nursing. Minimum of 6 months experience in a clinical setting To meet our framework compliance requirements including DBS, Occupational Health, Clinical References and Updated CV Right to work within the UK – Proof will be required. In return Pulse Nursing will offer you the following benefits: Wee
Pulse Nursing are currently seeking Band 5 & 6 Registered Neonatal Nurses to join our growing team to work for Barts Health NHS Trust. Barts Health NHS Trust currently have a high volume of shifts available and as a Pulse healthcare professional, you get the first choice of the best shifts! This current opportunity will give you the flexibility to book in advance so you can plan ahead and in turn, be in control of your schedule. With Barts being one of Pulse Nursing’s priority clients, we can offer a great deal of shifts within this trust. We are offering a variety of shift patterns, including the option of full-time equivalent hours, in Barts Health Trust paying between £19.72 - £38.23 per hour. As a Band 5 Neonatal Nurse, you will provide high-quality care to premature and sick newborns in the Neonatal Unit. Working alongside a multidisciplinary team, you will use your expertise to deliver specialist care, support families, and ensure the best possible outcomes for your tiniest patients. Key Responsibilities: Provide holistic, family-centered care to premature and critically ill newborns. Assess, plan, implement, and evaluate individualized nursing care plans. Administer medications, treatments, and life-support care in line with neonatal protocols. Support parents and families, providing education, emotional support, and guidance. Work collaboratively with a multidisciplinary team, including neonatologists, paediatricians, and allied health professionals. Role Requirements: Registered Nurse (RN) with a valid NMC registration Completed Neonatal Intensive Care (NICU) training. Passionate about neonatal care and committed to providing high-quality, compassionate nursing. Minimum of 6 months experience in a clinical setting To meet our framework compliance requirements including DBS, Occupational Health, Clinical References and Updated CV Right to work within the UK – Proof will be required. In return Pulse Nursing will offer you the following benefits: Wee
Pulse Nursing are currently seeking Band 5 & 6 Registered Neonatal Nurses to join our growing team to work for Barts Health NHS Trust. Barts Health NHS Trust currently have a high volume of shifts available and as a Pulse healthcare professional, you get the first choice of the best shifts! This current opportunity will give you the flexibility to book in advance so you can plan ahead and in turn, be in control of your schedule. With Barts being one of Pulse Nursing’s priority clients, we can offer a great deal of shifts within this trust. We are offering a variety of shift patterns, including the option of full-time equivalent hours, in Barts Health Trust paying between £19.72 - £38.23 per hour. As a Band 5 Neonatal Nurse, you will provide high-quality care to premature and sick newborns in the Neonatal Unit. Working alongside a multidisciplinary team, you will use your expertise to deliver specialist care, support families, and ensure the best possible outcomes for your tiniest patients. Key Responsibilities: Provide holistic, family-centered care to premature and critically ill newborns. Assess, plan, implement, and evaluate individualized nursing care plans. Administer medications, treatments, and life-support care in line with neonatal protocols. Support parents and families, providing education, emotional support, and guidance. Work collaboratively with a multidisciplinary team, including neonatologists, paediatricians, and allied health professionals. Role Requirements: Registered Nurse (RN) with a valid NMC registration Completed Neonatal Intensive Care (NICU) training. Passionate about neonatal care and committed to providing high-quality, compassionate nursing. Minimum of 6 months experience in a clinical setting To meet our framework compliance requirements including DBS, Occupational Health, Clinical References and Updated CV Right to work within the UK – Proof will be required. In return Pulse Nursing will offer you the following benefits: Wee
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