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Your job is more than a job You overthink every care option and scenario because, as a Care Manager, you're the hub of your patient's case management and care plan. You assure quality through the continuum of care, collaborate with members...

Job Summary: Collaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental...

Job Description: This job description applies to Nurse Manager and Nurse Manager-Complex. The difference is the scope level below. This role involves managing and supervising nursing departments. Collaborating with nursing leaders and other...

CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare...

We are seeking a Registered Nurse (RN) to join our Utilization Management team. In this role, you will perform concurrent reviews, prior authorizations, medical necessity reviews, discharge planning, and...

Benefits: 401(k) Competitive salary Dental insurance Health insurance Paid time off Signing bonus Training & development Vision insurance Outpatient Case Management West Los Angeles VAMC 11301...

Actalent is seeking an experienced Care Management Supervisor (RN) to lead a remote Adult Case Management team in California. You will oversee staff performance, drive outcomes, and foster collaboration with providers, members, and community...

Molina Healthcare Illinois Virtual Hiring Event Molina Healthcare is looking for dedicated Care Managers (RN, LPN, BH licensed) across Illinois to provide compassionate, coordinated care to our members. Join a team committed to improving...

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...

Guidehealth is seeking a Care Manager to guide patients and families through complex health journeys. This remote role blends clinical RN expertise with holistic care, focusing on medical, behavioral, and social needs to empower wellness and...

Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

Utilization Management Nurse Join us in our mission to transform healthcare! NirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

Spectrumforce Technologies, Inc. is seeking a Care Manager (RN) to support Medicaid members remotely in Florida. The role involves reviewing referrals, proactive outreach, and guiding members through care management, education, and coordinated...

ArchWell Health is seeking a Nurse Care Manager to coordinate and evaluate care for patients with acute and chronic conditions across the care continuum. The role involves developing individualized care plans and executing them with the care team...

Unit Nurse Manager (RN/LVN) We are seeking a Unit Nurse Manager (RN or LVN) to provide clinical leadership and oversight for nursing care within an assigned unit. This role is responsible for supervising nursing staff, ensuring...

Unit Nurse Manager (RN/LVN) Department: Nursing Reports To: Director of Nursing Employment Type: NonExempt Location: Skilled...

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 sponsorship...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our...

Sentara Health is seeking a Remote Integrated Case Manager who will conduct telephonic and in-person assessments, develop and oversee comprehensive care plans, and coordinate authorizations within the benefits structure. The role requires an RN...

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...

UnitedHealth Group is seeking a Telephonic RN Case Manager to act as the primary contact for members with complex medical and social needs. You will conduct telephonic assessments, create person‑centered care plans, and coordinate services...

CVS Health Corporation in Illinois is seeking a full-time Transition of Care Case Manager (RN) to coordinate post-discharge care for high-risk members. You will develop Individualized Care Plans, work with interdisciplinary teams, and guide...

Sedgwick is hiring a Telephonic Case Manager (US Telecommuter) to support injured workers by planning medical care and advocating for timely returns to work. You will assess needs over the phone, coordinate services, and communicate with care...

Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges.