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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...

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...

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...

The Veterans Health Administration at the Charleston VA Medical Center seeks a Nurse Manager (RN) to lead and supervise designated units within Community Care. The role emphasizes staff development, evidence-based practice, and collaboration with...

Job Description Join a team that's shaping the future of pediatric care. Children's Hospital Los Angeles is consistently ranked among the top 10 children's hospitals in the nation, delivering world-class care through more than 350...

Are you passionate about serving seniors? Do you want to be part of team that strives to create experiences that celebrate our seniors?

Centene Corporation seeks an experienced RN Care Manager to assess, plan, and facilitate complex care management for members with primarily physical needs. The hybrid position requires residing in Delaware with an active RN license and in-person...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and...

Hone is a virtual medical clinic for men's/women's health, hormones, weight loss, and longevity.We are remote-first and fast-growing, focused on candid communication and joy.The Role:You will manage patient-doctor communications and clinical...

Integra Partners seeks an experienced Utilization Management Nurse Supervisor to lead the UM nursing team, ensuring performance, accountability, and professional development. You will conduct regular 1:1s, manage performance reviews, and drive...

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care...

CVS Health is seeking a Care Manager in Illinois to advocate for members enrolled in Medicare/Medicaid, coordinating care with providers, community organizations and family supports to address complex health and social needs. This role focuses on...

Optum is seeking a Fertility Utilization Management RN to work remotely within the United States. You will assess and determine the appropriateness of inpatient and outpatient services, translating clinical concepts into practical care-management...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

Cambia Health Solutions is seeking an experienced Utilization Management Nurse to support clinical reviews and care coordination across Oregon, Washington, Idaho, and Utah. This role emphasizes medical necessity determinations and collaboration...

Cunningham Children0s Home in Urbana, IL seeks a Nurse Case Manager to support residential programs with medical case management, screening, education, counseling, and medication management, while networking with community health providers. The...

Ethos Risk Services is seeking a full-time Clinical Recruiter (REMOTE) to lead hiring for the Case Management division. You will own full-cycle recruiting for nurse case managers and other clinical pros, from posting to onboarding, ensuring a...

Trillium Health Resources in North Carolina is hiring a Nurse Manager, Utilization Management – Physical Health to lead day-to-day utilization management operations and oversee authorization workflows. The role requires clinical oversight, staff...

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...

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...

Yoh, a Day & Zimmermann company, is seeking an Utilization Management Nurse Coordinator (RN) for a remote contract opportunity based in Fairfield/Redding, CA. Training is onsite for 3 weeks, then remote with regular weekday hours and one weekend...

Provide essential clinical and administrative support to a remote healthcare team across Canada. Manage laboratory results, pharmacy communications, referrals, and patient follow-ups. Requirements: Current...

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,...

Provides direct nursing care including: assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of...