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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...

The Ambulatory Case Manager, RN is responsible for providing comprehensive care coordination and case management services to members, ensuring seamless...

Care Career is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Case...

California residency required. Job Summary Leads and supervises a multidisciplinary team of healthcare services professionals in some or all of the following functions: care management,...

The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace...

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...

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...

Grievance & Appeals Nurse Specialist Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value...

To support a growing healthcare team, the full-time Remote RN Care Manager will manage an assigned patient panel, focusing on individual healthcare needs, collaborating with interdisciplinary teams, and advocating for patients while working...

Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS -...

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...

Pay Range: $35.92 - $53.88 A successful candidate's actual pay rate will be based on several factors including relevant experience, skills, training, certifications and education. This position is responsible for the coordination of patients...

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

Explore meaningful roles that let you make an impact in healthcare while growing your career with purpose, innovation, and global opportunities.Senior Care Specialist (Registered Nurse) – Work From Home About Sagility Sagility combines...

WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of...

A health services provider is seeking a Care Manager RN for a remote, contract role in Detroit. This position involves leading a multidisciplinary team to deliver holistic care and requires a Nursing Diploma or Associate's degree, with a...

A healthcare solutions company is seeking a remote Case Management Nurse to lead a multidisciplinary team providing holistic care. The role requires a compact RN license and offers a pay range of $37.00/hr - $39.00/hr. Candidates should have 3...

Cadence in Dallas, TX is seeking an RN Supervisor to lead a remote team of Registered Nurses in a high-volume triage environment. This role demands strong clinical judgment, operational management, and performance coaching to maintain quality...

CASE MANAGER LIAISON NURSE - OUTPATIENT COMPLEX CARE COORDINATION - PEDIATRICS! MUST LIVE IN WESTERN WA WITHIN COMMUTABLE DISTANCE TO A KPWA MEDICAL CENTER FLEXIBLE ROLE WORKING 4-10'S ~ (3) DAYS ONSITE KPWA MEDICAL CENTER AND (1) DAY REMOTE ~ MON...

Discover Vanderbilt University Medical Center Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim...

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...

Great-Lakes-Management-Co. seeks a PRN/On Call Triage RN for a remote position serving residents in MN, WI, and CO. You must reside in MN, WI or CO and hold an active RN license in those states. The role offers on-call shifts with remote...

Life at aptihealth aptihealthis a fast-growing health tech company transforming behavioral healthcare. Our digital platform and affiliated medicalgroupmake it easier for people to access high-quality care when and where they need it.You'lljoin a...

TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated...

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...