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

Nurse Reviewer Contract Duration: Initial 6-months Pay: $27.50/hr on W2 Start Date: 9/8/2026 Location: Fully Remote (US Only) LPN State...

The Lead, RN Case Manager is an experienced RN Case Manager who provides clinical and operational support to the Care Management leadership team. In addition to performing the full scope of an RN Case Manager, the Lead is...

Overview: RN / Registered Nurse, Home Health ...

Clinical expertise meets analytical precision in a role that directly shapes how patient care is captured, understood, and valued across the health system. As a Clinical Documentation Specialist, you bring a seasoned nursing perspective into a...

Registered Nurse (RN) - Clinical Documentation Specialist (Part Time) Remote Clinical expertise meets analytical precision in a role that directly shapes how patient care is captured, understood, and valued across the health system. As a...

Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah *Please be advised that this role is part of our candidate pool, which allows us to identify and attract...

Description & Requirements Maximus is hiring a Clinical Reviewer RN/LPN to support our LTSS Tennessee contract. Areas will include but are not limited to PASRR Level 1 and Katie Beckett. In this role, you will review...

Become a part of our caring community At Humana, we put the health and well-being of our members at the center of everything we do. As an Onsite Care Coordination Nurse, you will play a vital role in supporting members during critical moments in...

Telephonic Care Manager Opportunity Are you an experienced nurse looking for the next challenge in your career? Do you have knowledge of case management or care coordination? Check out this fantastic new opportunity! UPMC Health...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

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,...

Job Summary: The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating...

Job Details Telephonic Triage Nurse Case Manager (Remote) 2026-1475 Dallas, TX, USA Medical Case Management Full Time Description Overview Are you looking to make a difference by providing...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13180 Salary Range:...

RN Utilization Management 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...

Case Manager The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Nurse, Concurrent Review Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria, including admission reviews, continued stay reviews, transitional care...

Company Description WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services,...

Resp & Qualifications PURPOSE: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the...

Job Summary As a Clinical Services Manager - RN Telephonic Case Management, you will ensure optimum recovery on every claim while establishing trust, providing education, delivering information, and care. You will provide case direction to...

Health And Social Services Coordinator At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people...

Join Sailor Health Join a mission-driven team transforming senior mental health care with compassion, flexibility, and support. Work remotely from your home and on your own hours. Sailor will take care of finding patients to you so that...