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*Job Summary and Responsibilities* As our Nurse Shift Manager, you'll oversee a department of frontline nurses caring for patients. Every day you will advocate for your fellow nurses as you support them in reaching their full potential,...

Care Manager Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

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 for the better. Come build the health care system...

*Job Summary and Responsibilities* As our Director Nursing Perioperative Services at St. Mary Medical Center, you will be responsible for Surgical service departments including OR, PACU, GI, Short Stay (Pre and Post Op Outpatient Surgery), and...

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...

Join Us at our Virtual Job Fair to learn more about this position! Wednesday, October 7th | 12pm - 2pm EDT Register here: UHC Community & State Massachusetts Virtual Job Fair...

Job Description: The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing...

Become a part of our caring community Great nursing careers should leave room for your life, too! As an RN Care Manager, you will enjoy no nights or weekends while making a meaningful difference for Wisconsin Family Care Program members in your...

*Job Summary and Responsibilities* As our Nurse Shift Manager, you'll oversee a department of frontline nurses caring for patients. Every day you will advocate for your fellow nurses as you support them in reaching their full potential,...

We are so glad you are interested in joining Sutter Health!Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone support to Sutter Health...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This is a hybrid remote position with occasional float in-person at our Mount Auburn Primary Care offices in the Cambridge area.

Jobgether is seeking a Case Manager – Utilization Review Specialist for a remote role based in the United States. You will conduct admission and concurrent reviews, assess medical necessity, and coordinate appeals to support patient care and...

*Job Summary and Responsibilities* As our Nurse Shift Manager, you will help lead and coordinate our exceptional nursing team so they can deliver timely, compassionate, and life-saving care to patients in critical situations. Every...

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations. You will work with the One Home/Home Solutions Utilization...

Care Manager (RN) A TEAM OF DIFFERENCE MAKERS: At Author Health, we're revolutionizing how mental health care is delivered, and we want you to be part of it! Our mission is to bring compassionate, high-quality care to...

Inpatient Care Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting...

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...

Centurion Health is seeking a Full-Time CQI Specialist for our Regional Office team. This remote/traveling position requires residing in Northern Illinois with a commutable distance for site visits (2-4 days/week) and occasional travel to...

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...

CVS Health is seeking an experienced RN Utilization Management Nurse Consultant for Medicare joint procedures. This remote, full-time role follows a Monday–Friday schedule (9:00 am–5:30 pm in your time zone) with occasional evenings/holidays,...

We are so glad you are interested in joining Sutter Health!Organization: SHSO-Population Health Services-UtahPosition Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and thorough intake services by...

The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...

Conduct prospective, concurrent, and retrospective reviews for medical necessity and appropriateness of services. Collaborate with UM Medical Director on reviews and final determination. Draft denial language to ensure...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...