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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,...

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...

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...

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...

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...

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,...

UnitedHealthcare in Tennessee seeks a Licensed Field Care Coordinator to coordinate care for medically complex members, delivering education, self-management support, and advocacy. This field-based, remote role requires strong clinical skills and...

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...

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...

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...

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...

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...

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...

A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must...

The Ambulatory Case Manager, RN is responsible for providing comprehensive care coordination and case management services to members, ensuring seamless...

Upper Peninsula Health Plan (UPHP) is seeking a Remote Community Based Clinical Coordinator - Care Manager. The role involves evaluating members, coordinating services, and ensuring high-quality, cost-effective care across care settings.

A healthcare staffing agency is seeking a Remote Nurse Care Manager to guide high-risk members through their healthcare journeys. In this role, you will engage through telephonic outreach, develop care plans, and collaborate with a...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plan is currently hiring a Medical Policy Research Specialist/ Registered Nurse (RN) - Remote in Virginia! ...

Harris Health is seeking a Nurse Manager to oversee operations and care delivery for one or more clinics or units. You will manage human resources, quality, and financial aspects while aligning with nursing leadership and professional practice...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

SCAN Group is seeking a remote RN to enhance frail seniors' ability to age in place by delivering person-centered care via telephonic care coordination. You will develop and implement plans of care, educate members, and coach them to manage...

Qualifications Basic Requirements: English Language Proficiency In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English Graduate of a school of...

The Hong Kong Study Skills Research Institute in Milwaukee, WI, is seeking a Licensed Practical Nurse (LPN) for a fully remote role. This position offers a competitive pay range of $21 - $28 per hour, stable Monday-Friday schedule, and...

Pay Range: $35.92 - $53.88 A successful candidate's actual pay rate will be based on several factors including relevant experience, skills, training, certifications and education. This position is responsible for the coordination of patients...

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 goals and needs, as well as...