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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...

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...

Job Description You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive...

Job DescriptionRegistered Nurse (RN) Care Management Specialist Location: Remote- Onsite for Training (Must reside within 2 hours of Columbia, SC) Pay Rate: $30/hour ScheduleMonday through...

CVS Health is seeking an experienced Registered Nurse for a remote, work-from-home Case Manager role across the US. You will collaborate with patients, care teams and providers to apply clinical guidelines and coordinate utilization management for...

Nursing Care Coordinator Performs an age specific plan of care for a designated group of patients using the nursing process of assessment, diagnosis, outcome identification, planning, implementation and evaluation of patient care.

Santa Barbara Cottage Hospital is seeking an experienced RN/LPN to perform remote clinical reviews for appeal cases. You will review medical records, apply InterQual criteria, and prepare clinical determinations for physician review. The...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

A healthcare services provider in Cleveland, Ohio, is seeking a Case Manager Nurse Advocate. This position offers remote work flexibility and requires an active nursing license and a Bachelor of Science in Nursing (BSN). The ideal candidate will...

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...

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...

CVS Health is seeking an experienced RN Case Manager to join our remote team serving members across multiple states. You will conduct telephonic care coordination, apply clinical guidelines, and collaborate with care teams to direct appropriate...

Description Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical...

Sedgwick in the United States is seeking a Telephonic Case Manager to collaborate with injured workers, employers and medical providers. You will develop a case management strategy to facilitate medical recovery and support a successful return to...

Performs an age specific plan of care for a designated group of patients using the nursing process of assessment, diagnosis, outcome identification, planning, implementation and evaluation of patient care. Collaborates with physicians and other...

To support a growing healthcare team, the full-time Remote RN Care Manager will manage an assigned patient panel, focusing on individual healthcare needs, collaborating with interdisciplinary teams, and advocating for patients while working...

Select how often (in days) to receive an alert: Date: Sep 21, 2026 Location: Any city, KS, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of...

Registered Nurse (RN) Clinical Documentation Specialist Job Type: Remote FT | Days Your experience matters At Highpoint Health Sumner we are driven by a profound commitment to prioritize your...

Highpoint Health Sumner is seeking a Registered Nurse (RN) Clinical Documentation Specialist to join as a remote FT (days). You'll contribute by applying plan-of-care interventions and driving patient-care innovations with advanced technology.

Nurse Manager Job Type: Permanent Position Urgency: Normal Offering Nursing Profession: Nurse Management Specialty: Nurse Manager OR Shift Details: Shift 08:00 AM - 04:00 PM Shifts Per Week: 5...

Job Description: The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing...

Unit Notes - Unit: PACU - # beds: 15 cubicals - Phase 1 and Phase 2: Phase 1 just be knowledgable of Phase 2 - Certs: BLS, ACLS, PALS, preferred-CPAN or CCRN- 2 years of recovery/ICU experience. 1st time traveler okay - Ratios:...

Oscar Health is seeking a Utilization Review Nurse to perform medical necessity and level of care reviews from a home office. You will gather information by phone/fax, apply guidelines, and coordinate with care providers to determine appropriate...

Employment Type: Full time Shift: Night Shift Description: Position Summary: Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to...

A healthcare recruitment agency is seeking a licensed Psychiatric Mental Health Nurse Practitioner (PMHNP) to work as a 1099 contractor. This role offers flexible scheduling and remote work, allowing you to manage your own caseload while focusing...