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JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure...

Texas Health Resources is seeking an Utilization Management RN - Clinical Review to support remote admissions reviews across THR facilities. You will assess initial admission status for inpatient, observation, and outpatient settings, using...

Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with...

To support patient care initiatives, the full-time Florida Licensed Utilization Management RN will monitor admissions, perform medical necessity reviews, and manage concurrent denials while working remotely four days a week.Key...

Nurse Care Manager Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's shaping the...

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...

Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah *Please be advised that this role is part of our candidate pool, which allows us to identify...

Working as a Nurse Case Manager at Cunningham Childrens Home means youll be part of team that is dedicated to supporting youth in critical need of emotional, psychological, and physical care. Located in Urbana, IL, Cunningham Children's Home is a...

Care Manager Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will...

Details Client Name Kaiser Permanente Los Angeles Medical Center Job Type Permanent Offering Nursing Profession Nurse...

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,...

Highmark Inc. is seeking an experienced RN in a remote role, with weekend availability on Saturdays and Sundays plus three weekdays. The position emphasizes utilization management, care coordination, and provider/member education. The RN...

A leading healthcare provider is seeking an Associate RN for a remote role dedicated to acting as a care guide and advocate for patients. The candidate must hold a valid RN license in a compact state or California. Responsibilities include...

Responsibilities: How you'll change lives...

Job DescriptionPart and Full-time roles are eligible for a $30,000 sign-on bonus — apply today to learn more!Varied scheduling options are available, including 8-hour, 10-hour, and 12-hour shifts, as well as a Special Weekend Option.Are you an...

Humana seeks a Manager, Utilization Management Nursing – LTSS to lead and oversee UM operations for LTSS members. The role requires an IL-licensed RN with 3+ years in UM and leadership of supervisors. You will collaborate with Care Management,...

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...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Job Description The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S)...

Centene is seeking a licensed Practical Nurse or Registered Nurse for a remote utilization management role based in Oklahoma. You will review prior authorization requests for medical necessity and coordinate with medical teams to ensure...

Nurse Care Coordinator (RN) Clarity Pediatrics is reimagining pediatric chronic care, starting with ADHD. After successfully launching our virtual clinic for ADHD and anxiety, we are expanding our pediatric care platform to address other...

Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Garden Grove Hospital Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand...

Job Title: CWP Immunizing Nurse Float - Vaccination Initiative Address: Van Nuys, CA Job Description Administer vaccines (flu, COVID, MMR) to patients. Display empathy and compassion for patients, customers, caregivers, and colleagues. Adapt to...

Cross Country Education is seeking a local contract nurse RN School RN for a local contract nursing job in Downey, California. Job Description & Requirements Specialty: School RN Discipline: RN Duration: 41 weeks 36 hours per week Shift: 12 hours...

DWC seeks to bring on board a Registered Nurse who can provide our residents with the focused support they need to address chronic health challenges. The RN will work with residents to assess pain, mood, strength/balance, risk of falls,...