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Virtua Health is seeking a remote RN to support the application of medical necessity tools, ensuring compliance and achieving positive patient outcomes. You will collaborate with Physician Advisors, manage denials, and document review activities...

WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of...

Job DescriptionJob Summary Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities...

Staffmark Group is recruiting a Registered Nurse for a remote role. Primary duties include reviewing peer review reports, ensuring evidence-based rationales, and ensuring compliance with client, contract, and regulatory standards. The ideal...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...

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...

Molina Healthcare is seeking a Registered Nurse Care Manager to support care management and LTSS services in Wisconsin. The role collaborates with a multidisciplinary team to coordinate member care across settings, with emphasis on high-need...

Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical...

Humana is seeking a skilled Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. You will report to the Manager of Utilization...

Description The purpose of this position is to provide medical evaluation, clinical management, and coordination of medical services for Publix associates that have sustained on-the-job injuries. The Nurse Case Manager is...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

ADP, Inc. is seeking an Outpatient Case Manager to provide intake and case management for members with chronic conditions and related comorbidities. You will develop individualized care plans with the member, caregiver, and PCP, and coordinate...

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...

Description: Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient...

Molina Healthcare is seeking an experienced healthcare leader based in California, with strong RN licensure and extensive delegation experience in IPA settings. The role directs a multidisciplinary team to coordinate integrated care, with focus on...

Guidehealth is seeking an Illinois-licensed registered nurse to join its remote Value Based Care Services team as an RN Case Manager. You will conduct telephonic outreach, assess needs, coordinate care, and document in compliance with...

At St. Luke's, our dedicated team of Remote Patient Management RNs are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which...

To assist injured workers in receiving timely and appropriate medical care, the full-time Remote RN Telephonic Case Manager will assess, plan, implement, and coordinate care while working Monday through Friday from 8:30 am to 5:30 pm local...

Overview The Quality Outcomes Coordinator (QOC) works at the unit-level, in collaboration with bedside staff and unit leaders to deliver effective, efficient, high-quality care. The QOC continuously evaluates care at the bedside, identifies gaps...

Spectrumforce Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for a 3-month contract to hire. The role is remote with work location listed as Remote-MS CST, schedule 8 am-5 pm Central time, with occasional weekend...

Description RN- Registered Nurse - Case Manager Specialty: Case Manager Location: Los Angeles,CA,00000 Start Date: 2026-10-05 End...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...