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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.

Clinical Specialist Base Compensation Range $72,000 - $85,000 USD Compensation & Benefits Competitive cash compensation Comprehensive health plans Generous PTO Future focused 401k match...

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

Clinical Documentation Integrity Specialist Evaluates the day to day documentation practices of the Medical Staff and healthcare team on a complex patient population, and offers education and recommendations in accordance with the...

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...

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...

Nurse - Clinical Review Performs utilization review of cases to determine if the request meets medical necessity criteria in accordance with medical policies agreed upon with the Client and any applicable governing body. Facilitates...

Elevance Health is seeking a Telephonic Nurse Case Manager II to coordinate care for members with complex needs via telephone, enabling virtual work with mandatory in-person trainings as required. Candidates must hold an RN license and have...

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...

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...

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:...

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...

Job Description TactStaff is seeking a dedicated Registered Nurse Case Management - Hospital for a rewarding opportunity located in Glendale, CA. At TactStaff, we prioritize being your lifelong career ally. This dedication is...

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 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...

Resp & Qualifications We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for...

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

Parenteral Services Clinical RN Specialist The Parenteral Services Clinical RN Specialist provides clinical support to the Parenteral Services team through advanced nursing expertise, education, care coordination, and operational...

Netsmart Technologies, Inc. is seeking a Registered Nurse with utilization management experience to review ED admissions and apply InterQual/MCG criteria for medical necessity. You will discuss documentation with ED physicians and ensure proper...

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...

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...

CareHarmony is seeking an experienced Licensed Practical Nurse – LPN to join our remote Intake team. The role focuses on comprehensive care coordination for chronic patients, conducting initial assessments, and guiding patients through their...

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...

Posting Date 10/06/2026 601 Hawaii St, El Segundo, California, 90245-4814, United States of America RN Case Manager - Position Highlights Location: Pasadena, CA Hybrid - (ESKD) This is a...

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...