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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 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,...

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...

Humana, Inc. is seeking an Oklahoma-based Telephonic Care Manager who assesses enrollees, plans care, and coordinates services to maintain or achieve optimal wellness. The role involves collaboration with a care management team and may...

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...

Phaxis - Healthcare is hiring for a REMOTE RN opportunity focused on Grievance & Appeals and Utilization Review. The role requires candidates to reside in New York State and hold an active NY RN license. The schedule is Monday–Friday, 9...

*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...

Care Manager 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...

Humana's CenterWell Specialty Pharmacy is seeking a Care Manager, Telephonic Nurse 2 to support patients with complex conditions. This remote role conducts telephonic assessments, educates patients on medications, and creates individualized care...

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...

*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...

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,...

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...

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...

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...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Sentara Health is seeking a Remote Utilization Review Registered Nurse based in Virginia. The role focuses on utilization review and prior authorization for inpatient and outpatient cases, with emphasis on upholding regulatory criteria and...

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...

Brighton Health Plan Solutions is seeking an experienced Utilization Management Nurse to perform medical necessity and benefit reviews for clients while working remotely in a fast-paced environment. The role requires current LPN licensure and...

RN Status Review Specialist It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Use your nursing expertise in a strategic, non-bedside role. As an RN Status Review Specialist, you'll evaluate patient...

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults-and we're looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living...

Job TitleFacilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS. Reviewing paper and electronic...

Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including...

Sedgwick is seeking an RN Field Case Manager to work face to face with injured workers and medical providers, supporting advocacy, expedient treatment, and return-to-work efforts. The role blends remote work with necessary in-person interactions...

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