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Your Role The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Care Management Team Member The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Clinical Nurse Professional Development Educator Advanced How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At...

Workers' Compensation Care Coordinator Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors and...

Central Intake Nurse Job Type: Full-Time Remote possible Benefits Offered: Healthcare Dental Vision PTO 401K Your Job Summary The Central Intake Nurse...

Cambia Health Solutions seeks an experienced Utilization Management Nurse to support member care across multiple states. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and optimal outcomes,...

The Clinical Quality Assurance Coordinator is responsible for ensuring case reports are of the highest quality and integrity, and in full compliance with client contractual agreements, regulatory agency standards and federal and state mandates.

Elevance Health is seeking a Telephonic Nurse Case Manager I to provide remote care management for members with complex and chronic conditions. The role requires a BA/BS in a health-related field, a current RN license, and multi-state licensure...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

Utilization Review Case Manager The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity...

Compliance Nurse Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders,...

Care Career is seeking a travel nurse RN Case Management for a travel nursing job in Glendale, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date:...

Pride Health is seeking an experienced Registered Nurse (RN) with Utilization Management experience to support clinical quality review and AI model development for prior authorization use cases. The ideal candidate will review records, apply...

Registered Nurse (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

Be part of a soul-hearted approach to healing Alsana is a national leader in eating disorder treatment, offering a holistic, soul-hearted approach to recovery for adults and adolescents of all genders. We exist to be a source of hope...

Utilization Management Admissions Liaison RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide health...

Details Client Name Adventist Health Glendale - Westways Job Type Travel Offering Nursing Profession Registered Nurse (RN)...

Overview The OP Care Management RN provides care management and population health services to patients. The primary target population served is the stratified risk patient or patients with high vulnerability at times of...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

Responsible for utilization review work for emergency admissions and continued stay reviews Responsibilities Review and evaluate electronic medical records of emergency department admissions and screen for medical...

Are You Ready to lead in Healthcare? We are currently seeking a Full-Time Case Manager(LPN/LVN) to join our outstanding healthcare team! Salary Range: $83,203-$93,936 per year We are passionate...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - HSS Clinical Coordinator RN - Telecommute in Texas (2391171) HSS Clinical Coordinator RN - Telecommute in Texas - 2391171 At...

RN Case Manager This position functions autonomously and in collaboration with all members of the healthcare team to coordinate and facilitate quality, cost-effective care while minimizing fragmentation of the healthcare delivery system...

Details Client Name Adventist - Glendale Job Type Travel Offering Nursing Profession RN Specialty Case...

Pay Package: Total weekly gross $ 2979 for 40 hrs Job Description: Tittle: RN Case Manager Location: Mission Hills, CA 91345 Duration: 13 weeks Guaranteed hours: 40 hrs Shifts: Day Job Description: Start Date:...