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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...

Fully remote (never coming onsite) Description: The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan...

JOB DESCRIPTION Job Summary Work Location: California - Ability to work remote, but selected candidate must reside in the state of California. This position requires California RN Licensure. Candidates must...

Job Details Field Nurse Case Manager (Remote) 2026-1480 Bethesda, Maryland, United States Medical Case Management Full Time Description Overview Are you looking to make a difference by...

Dimensional Health Care Associates, Inc. (DHCA) seeks an RN Case Manager/Delegating Nurse in Bowie, MD to manage client care and delegate tasks. The role includes travel to client homes, initial and periodic assessments, and coordination with...

CVS Health is seeking a Case Manager RN for a fully remote telephonic role focused on assessment, planning, and coordination of case management activities for members of Federal Plans. You will enhance member wellness and advocate for patients...

Medix is seeking a Remote Telephonic RN Case Manager to provide telephonic case management for chronically ill members within a C-SNP population. The role requires an active Compact State RN license or CA license and a strong commitment to patient...

Guidehealth, a data-powered healthcare company, is seeking a licensed RN Case Manager to work remotely from Wisconsin. You will collaborate with clients and members to promote wellness, navigate the health system, and manage case assignments from...

Optum NY seeks an RN Case Manager to coordinate referrals for high‑risk members, educate patients on illnesses and treatments, and support care plans across the continuum. The role emphasizes strong clinical expertise and collaboration with...

Company : Highmark Inc. Job Description :JOB SUMMARY This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal...

UnitedHealth Group's Optum Care at Home is seeking a Telephonic RN Case Manager to serve as primary contact for members with complex medical, behavioral health, functional, and social needs, coordinating care across Medicaid LTSS, home health, and...

Sedgwick is seeking a Telephonic Case Manager (RN) for a fully remote role in the United States. You will partner with injured workers, employers, and medical providers to develop case management strategies aimed at medical recovery and successful...

CVS Health is seeking a licensed RN to perform remote telephonic case management for fully and self-insured clients across multiple states. You will assess needs, apply clinical guidelines, and coordinate care with care teams to ensure appropriate...

Your job is more than a job You overthink every care option and scenario because, as a Care Manager, you're the hub of your patient's case management and care plan. You assure quality through the continuum of care, collaborate with members...

Case Manager Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases are maintained by Case Managers. The employee reports directly to the Supervisor, Case Management (LCSW). In addition, the role...

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...

Sentara Health in Richmond, VA is hiring an Integrated Case Manager, RN to coordinate patient care across the continuum. This remote-friendly, full-time role requires in-person assessments and travel to Winchester, Leesburg, Alexandria, and other...

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...

Ansible Government Solutions, LLC is recruiting multiple Remote Registered Nurse Case Managers to support the VA Office of Veterans Community Care. The role involves managing SEOC data, ensuring compliance, and reviewing provider and veteran...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Optum is seeking an experienced Telephone Case Manager RN to support a diverse member population with education, advocacy, and connections to necessary resources. This remote role operates Monday through Friday, 8 AM–8 PM, nationwide across the...

Sedgwick is seeking a Telephonic Case Manager to join our team as a US-based remote, full-time role. You will collaborate with injured workers, employers, and medical providers to develop case management strategies that promote medical recovery...

Guidehealth is seeking a remote-based Care Manager (RN) to guide patients and families through complex health journeys. You will blend clinical expertise with holistic care, addressing medical, behavioral, and social needs while coordinating...

UnitedHealth Group is seeking a Telephonic RN Case Manager to act as the primary contact for members with complex medical and social needs. You will conduct telephonic assessments, create person‑centered care plans, and coordinate services...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...