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American Traveler is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Glendale, California. Job Description & RequirementsSpecialty:...

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

Job Description & Requirements Women's Health Nurse Practitioner (NP) StartDate: ASAP Available Shifts: Day 8 Pay Rate: $82.45 - $89.25 This facility is seeking a Women's Health Nurse Practitioner (NP) for locum tenens support...

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...

Humana Inc. is seeking a Pre-Authorization Nurse to review prior authorization requests, determine medical necessity, and educate providers on utilization management processes. The role requires clinical judgment, independent decision...

Be part of a soul-hearted approach to healing Alsana is a national leader in eating disorder treatment, offering a holistic, soul-hearted approach to recovery for adults and adolescents of all genders. We exist to be a source of hope...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding...

Supports the values of service excellence, teamwork, and integrity while managing patient care.Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers.Qualifications:Requires a current RN license, nursing diploma or...

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...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

Humana seeks a Pre-Authorization Nurse to review prior authorization requests, perform medical necessity assessments, and educate providers on utilization processes. The role requires an active RN license (VA or compact with eNLC), 2+ years in...

Sedgwick is seeking an Experience Utilization Review Coordinator to join a collaborative team supporting clinical staff. You will triage and assign UR cases, collect essential information, and enter data accurately into our claims/management...

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...

Cunningham Children's Home in Urbana, IL is seeking a Nurse Case Manager to join our team supporting youth in emotional, psychological, and physical care. This role involves medical case management, screening, education, counseling, and...

Case Manager LVN Days Join our team in Los Angeles, CA, as a Case Manager LVN, focusing on patient care coordination and discharge planning. Position Details: Contract: 13 weeks, 40 hours/week, 9am-5:30pm, includes...

Job DescriptionRegistered Nurse (RN) Care Management Specialist Location: Remote- Onsite for Training (Must reside within 2 hours of Columbia, SC) Pay Rate: $30/hour ScheduleMonday through...

Actalent is seeking a Case Management Nurse to deliver client-centered case management across the continuum of care. The role blends direct patient contact with care coordination, education, advocacy and resource navigation to improve outcomes.

Full-time Company Description WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare...

CorVel seeks an experienced Utilization Review Case Manager to gather demographic and clinical information for inpatient and outpatient treatments, certify medical necessity, and assign length of stay to support the Case Management department.

Elevance Health is seeking a Utilization Management Representative I to coordinate precertification and prior authorization reviews. This full-time role supports calls, post services work, and data entry into the UM system with accuracy 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...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding experienced RNs to its clinical...

HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate discharge planning within Medicare, AHCCCS, Self-pay, and other payer guidelines. The...