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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...

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...

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...

Optum NV is seeking an RN Case Manager Telephone Advice Nurse to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll...

Nightingale Nurses is seeking a travel nurse RN Case Management for a travel nursing job in Glendale, California. Job Description & RequirementsSpecialty: Case...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management) .Candidate must be authorized to work in USA without requiring sponsorshipLocation: 100% Remote for California...

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...

RN CASE MANAGER – CARE MANAGEMENT DEPARTMENT - University of New Mexico Hospital – Albuquerque *Inpatient *Outpatient *Utilization Management *SRMC Care Management *Full Time *Part Time Receive 17% Weekday Nights, 26% Weekend Nights and 15%...

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...

Seeking a full-time RN Case Manager - Remote, who will manage care for members with complex and chronic needs by assessing, developing, implementing, and evaluating care plans while working primarily through telephonic communication.Key...

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...

Medlivo is seeking a travel nurse RN Case Manager, Acute Care Case Management for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty: Acute...

Kindred Hospital San Gabriel Valley Care Coordinator Kindred Hospital San Gabriel Valley is a 76-bed long-term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery...

Engage patients telephonically to assess needs and prioritize care.Collaborate with providers to coordinate care and transitions.Provide education and resources to patients and caregivers.What Will Make You Successful Here: Hold an active RN...

Redesigning heart health via virtual cardiac rehab for older adults.Mission-driven team of clinicians and engineers.Responsibilities:Review EMRs to determine eligibility and create orders.Conduct video intake assessments and treatment...

Description Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the patient's placement to be at...

Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM Position Type: ...

Utilization Review Case Manager The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity...

Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

Clinical Navigator Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an...

Working remotely in a full-time capacity, the RN Telephonic Case Manager will manage treatment plans for injured or disabled individuals, collaborating with healthcare providers and employers to facilitate effective recovery and return to work.Key...

Explore opportunities with Amedisys, part of the Optum family of businesses. We provide home health, hospice and community-based services that help people receive quality care where they feel most comfortable: at home. Rooted in personalized care,...

Clinical Documentation Integrity Specialist IIThe Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of...

JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance Abuse...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management) .Candidate must be authorized to work in USA without requiring sponsorshipLocation: 100% Remote for California...