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CVS Health is seeking an ICM Care Manager to assess, plan and coordinate patient care from a home-based setting with 25-50% travel within Passaic County, NJ. The role requires an active NJ RN license and a minimum of 3 years clinical experience,...

Guidehealth in the United States seeks an experienced RN Case Manager to work remotely with Illinois licensure. You will oversee member management, promote wellness, and support cost-effective care within a value-based care framework.

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

Guidehealth is seeking an Illinois-licensed registered nurse to join its remote Value Based Care Services team as an RN Case Manager. You will conduct telephonic outreach, assess needs, coordinate care, and document in compliance with...

Case Manager, RN- Utilization Review A Brief Overview The Utilization Review Case Manager validates the patient's placement to be at the most appropriate level of care based on nationally accepted admission criteria. Team member uses...

Description: Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical...

Virtua Health is seeking a remote RN to support the application of medical necessity tools, ensuring compliance and achieving positive patient outcomes. You will collaborate with Physician Advisors, manage denials, and document review activities...

Nurse Case Manager Position Type: Full-Time Contract Role Location: Work from home Work Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive) Schedule: Mon-Fri 8am-5pm EST...

Guidehealth is seeking a remote RN Case Manager with an Illinois nursing license to enhance member management, satisfaction, and cost effectiveness. You will support wellness, coordinate care, and navigate the healthcare system as part of the...

Talent4Health is seeking a travel nurse RN Case Management for a travel nursing job in Santa Monica, California. Job Description & RequirementsSpecialty: Case...

PIH Health Downey Hospital is seeking an RN Case Manager to oversee a continuum of care from pre-admission through post-discharge, ensuring efficient progression for assigned patients.Focus on appropriate utilization of hospital services,...

Molina Healthcare is seeking a Registered Nurse Care Manager to support care management and LTSS services in Wisconsin. The role collaborates with a multidisciplinary team to coordinate member care across settings, with emphasis on high-need...

EK Health is hiring a full-time Telephonic Nurse Case Manager (RN) for our Case Management Team. The role includes assessing, planning, coordinating, and evaluating service options to ensure injured workers receive timely, cost-effective care and...

Overview Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the...

Join to apply for the Case Manager (LVN or RN) role at Astrana HealthLocation: 1600 Corporate Center Dr., Monterey Park, CA 91754Compensation: $31.00 - $45.00 / hourDepartment: HS - ICMAstrana is looking for a RN/LVN Case Manager and we are...

Overview CORE Health Networks, the recognized leader in Integrated Occupational Medicine Services, provides integrated solutions to your occupational healthcare needs. We are currently seeking a full-time Case Manager (Registered Nurse)...

Description RN- Registered Nurse - Case Manager Specialty: Case Manager Location: Los Angeles,CA,00000 Start Date: 2026-10-05 End...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

ADP, Inc. is seeking an Outpatient Case Manager to provide intake and case management for members with chronic conditions and related comorbidities. You will develop individualized care plans with the member, caregiver, and PCP, and coordinate...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

PIH Health Downey Hospital is seeking an RN Case Manager to guide patients from pre-admission through post-discharge, ensuring smooth transitions and appropriate utilization of hospital services.You will focus on maximizing reimbursement from...

Details Client Name Dignity Health - California Hospital Medical Center Job Type Travel Offering Nursing Profession RN...

JOB DESCRIPTION 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...