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A healthcare organization is seeking an RN Case Manager to work remotely and facilitate case management activities, evaluating medical needs for overall member wellness. Candidates should have an active RN license, ideally compact, with at least...

UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient criteria, preauthorizations, and ensuring medical necessity while applying evidence-based...

A healthcare organization is seeking a remote RN to manage patient care related to chronic kidney disease. Responsibilities include ensuring continuity of care, coordinating treatment plans, and documenting patient information. Candidates must...

Central Health seeks a Nurse Case Manager to identify, screen, track and coordinate care for members with multiple co-morbidities and psychosocial needs. This role may work remotely with occasional travel to Austin, TX, under the Manager of Case...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Humana Inc. in the United States is seeking a Part C G&A Nurse (Utilization Management Nurse 2) to support case preparation, review medical documentation and coordinate appeal determinations. This remote, full-time role requires an RN with...

Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to...

ELM Management Services, LLC is seeking an ASC Pre-Admission Testing Registered Nurse (PAT RN) for part-time work in Atlanta, GA, with a remote option. The PAT RN will conduct telephonic pre-op assessments, coordinate clearances, and educate...

A healthcare organization is seeking a Texas licensed RN as a Care Manager to oversee care for complex cases. The role involves conducting assessments, developing care plans, and collaborating with a multidisciplinary team. Ideal candidates will...

Kaiser Permanente is seeking a registered nurse with utilization management experience to oversee skilled and custodial patient care in rehabilitation SNFs. The role focuses on benefits checks, discharge management, and coordinating a chronic...

A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must...

A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The...

SCAN Group is seeking a remote RN to enhance frail seniors' ability to age in place by delivering person-centered care via telephonic care coordination. You will develop and implement plans of care, educate members, and coach them to manage...

Job TitleWorks 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 necessity...

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 regulations...

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...

JR0059223 Tele-Health Nurse (Remote/LPN) (Open) Full-time McKesson requires new employees to be fully vaccinated for COVID-19 as defined by the CDC, subject to applicable, verified accommodation requests. McKesson is in...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

Job Description Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities for primary care...

Why Join Sunrise Senior Living At Sunrise Senior Living, we believe meaningful work starts with purpose. Our team members are passionate about making a positive difference in the lives of residents every day. At Sunrise Senior...

Salary: USD25 - USD28 per hour HealthVisionDentalWeekly Pay401kPrior Authorization Specialist (LPN /MA / Certified Medical Assistant) Position Title: Prior Authorization...

Optum is seeking an Inpatient Care Management Nurse to assess and interpret member needs, guiding utilization of health services to improve outcomes. You will collaborate with clinicians, perform case reviews, and support discharge planning from...

Qualifications VA Health Professional Trainees (HPT) pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. A HPT is an individual...

Overview It's inspiring to work with a company where people truly BELIEVE in what they're doing! When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing...

Registered Nurse (RN)-Torrance,CA Local Pay: $76.00/hour (W2) Join our team and make a meaningful impact by delivering exceptional care in a professional healthcare setting.