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California residency required. Job Summary Leads and supervises a multidisciplinary team of healthcare services professionals in some or all of the following functions: care management,...

Job Summary: The Clinical Nurse Specialist role at Kaiser Permanente Southern California Region is a clinical manager who partners with the operational manager to ensure that nursing staff delivers safe and effective care. The...

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...

A prominent healthcare organization is seeking a Telephone Triage Nurse Line Advisor in Saint Paul, Minnesota. The role requires a current Minnesota RN License and 3+ years of RN work experience. You will independently triage patient calls and...

Cadence in Dallas, TX is seeking an RN Supervisor to lead a remote team of Registered Nurses in a high-volume triage environment. This role demands strong clinical judgment, operational management, and performance coaching to maintain quality...

Namely is seeking California Based Nurse Care Managers for remote work to support members through their healthcare journey, ensuring needs are met with leading interventions. The position requires a Bachelor of Science in Nursing, 5+ years...

ELM Management Services, LLC is seeking an ASC Pre-Admission Testing Registered Nurse (PAT RN) for part-time work in Atlanta, GA, with a remote option. The PAT RN will conduct telephonic pre-op assessments, coordinate clearances, and educate...

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...

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,...

Vaya Health seeks a Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical necessity. You will reference standardized criteria and coordinate with physician peers when needed. This role is part of a...

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...

UnitedHealth Group is seeking an Inpatient Utilization Management Nurse, RN for a fully remote role serving the Sacramento area. The position requires 3+ years in acute care and 1+ year in utilization management, with certification in RN licensure...

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...

TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated...

Chronic Care Manager (RN)Vitability Health of New Jersey Remote PositionOur MissionAt Vitability Health of New Jersey, we believe great care goes beyond checklists and charts—it's about relationships, trust, and walking alongside patients as...

A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and...

An established industry player is seeking a dedicated Registered Nurse for a remote contract position focused on reviewing medical claims within the insurance sector. This role involves validating treatment plans using accepted criteria and...

Cambia Health is seeking remote Care Management RNs to provide case, disease, and care coordination from home within Oregon, Washington, Idaho or Utah. This role supports a person-focused health care experience with strong clinical judgment and...

UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services, assess member needs, and identify plans of care. This role supports collaboration with care teams and compliance while offering...

Humana Inc. in the United States is seeking a Part C G&A Nurse (Utilization Management Nurse 2) to support case preparation, review medical documentation and coordinate appeal determinations. This remote, full-time role requires an RN with...

Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to...

The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace...

A healthcare management firm is seeking an RN Care Management Coordinator – Compliance Specialist to ensure compliance with relevant regulations and standards. This remote position requires a minimum of five years of clinical experience, an...

Upper Peninsula Health Plan (UPHP) is seeking a Remote Community Based Clinical Coordinator - Care Manager in Michigan. The role supports care management across the continuum of care and involves in-home and facility visits, with a focus on...

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the...