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JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure...

Texas Health Resources is seeking an Utilization Management RN - Clinical Review to support remote admissions reviews across THR facilities. You will assess initial admission status for inpatient, observation, and outpatient settings, using...

Nurse Care Manager Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's shaping the...

Nurse Care Manager Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

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...

Details Client Name Kaiser Permanente Los Angeles Medical Center Job Type Permanent Offering Nursing Profession Nurse...

Nexus Health Systems is seeking a seasoned Utilization Review Registered Nurse (UR RN) for a fully remote role in the US. The ideal candidate will have experience in utilization review, case management, or behavioral health, and will ensure...

Responsibilities: How you'll change lives...

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely,...

Highmark Inc. is seeking an experienced RN in a remote role, with weekend availability on Saturdays and Sundays plus three weekdays. The position emphasizes utilization management, care coordination, and provider/member education. The RN...

Job DescriptionPart and Full-time roles are eligible for a $30,000 sign-on bonus — apply today to learn more!Varied scheduling options are available, including 8-hour, 10-hour, and 12-hour shifts, as well as a Special Weekend Option.Are you an...

Nurse Care Coordinator (RN) Clarity Pediatrics is reimagining pediatric chronic care, starting with ADHD. After successfully launching our virtual clinic for ADHD and anxiety, we are expanding our pediatric care platform to address other...

Cross Country Education is seeking a local contract nurse RN School RN for a local contract nursing job in Downey, California. Job Description & Requirements Specialty: School RN Discipline: RN Duration: 41 weeks 36 hours per week Shift: 12 hours...

Your Role The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Job Description The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S)...

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Garden Grove Hospital Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand...

Centene is seeking a licensed Practical Nurse or Registered Nurse for a remote utilization management role based in Oklahoma. You will review prior authorization requests for medical necessity and coordinate with medical teams to ensure...

Job Title: CWP Immunizing Nurse Float - Vaccination Initiative Address: La Mirada, CA Job Description Administer vaccines including flu, covid, and MMR. Display empathy and compassion while interacting with patients, customers, and colleagues.

GQR Healthcare is seeking a local contract nurse RN Case Management for a local contract nursing job in Los Angeles, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per...

Registered Nurse - Primary Care Location: Long Beach, CA Schedule: Monday-Friday, 8:00 AM-5:00 PM Setting: Onsite Position Summary We are seeking an...

Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with...

Home Care RN Location: Enfield, Windsor Regions Status: Full Time Bonus: Sign On Bonus Trinity Health Of New England At Home serves patients and their loved ones by providing a variety of in-home services including...

HealthTrust Workforce Solutions is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & Requirements Specialty: Case Management Discipline: RN...