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SCAN is seeking a part-time, telephonic care coordinator RN to support frail seniors in navigating the healthcare system and living independently. You will work with members remotely to assess needs, develop plans of care, and deliver health...

Industry: Private Employment Type: Full Time Work Hours: 8 Hours Locations: USA Scope The Medical Review Coordinator will perform her/his duties in accordance with MedWatch procedures, MedWatch review...

ChenMed is seeking a Physician Reviewer for Utilization Management to oversee UM cases and coordinate care across markets. You will participate in daily calls with health plans and teams, advising colleagues and driving quality improvements in...

Details Client Name Paramount ARU Job Type Travel Offering Nursing Profession RN Specialty Case...

Travel Nursing Case Management Position Nursing Profession RN Specialty Case Management Regular Pay Rate $24 Shift Details Shift 8 hour days Job Order Details Start Date 11/02/2026 End Date 05/03/2027 Duration 26 Week(s) Client Details...

Discover Vanderbilt Health With eight hospitals and over 180 clinics, we are the region's largest comprehensive academic health system. Vanderbilt Health has a long tradition of providing world-class care to the people of the Mid-South,...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic...

A leading healthcare provider is seeking a Registered Nurse for their LTSS department in New York. This role involves providing case management services, evaluating medical services, and managing appeals for denied services. Candidates must...

Hiring multiple RNs in various locations Care that meets patients where they are. Nursing that meets you where you thrive. UVA Health's Continuum Home Health team is redefining what high-level nursing looks like outside the hospital walls. We are...

Clinical Eligibility & Intake Nurse Part Time/1099 Contractor Fully Remote Monday-Friday; 3-5 hours per day / 15-20 hours per week*; schedule must overlap intake hours** Clinical Operations Reporting to:...

Registered Nurse RN Case Manager Title: Registered Nurse RN Case Manager Company: Great Nurses Home Care Reports to: Manager of Hospice Operations Location: Burbank, CA About Great Nurses Home Care Great...

Position Summary The RN Case Manager is responsible for performing clinical assessment and reassessment of acute care Inpatients for the purpose of performing utilization review, resource management and safe discharge...

Nurse Case ManagerUnder the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, acting as a resource to staff and physicians in resource efficiencies and...

GlobalHealth is seeking a licensed practical nurse in Oklahoma to perform telephonic case management and coordinate care for high‑risk members. The role emphasizes advocacy, education, and collaboration with providers to improve long‑term...

Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

Cambia Health Solutions, Inc. is hiring a Utilization Management Nurse who will conduct reviews to ensure medical necessity and cost-effective outcomes. Working from home within the states of Oregon, Washington, Idaho or Utah, you will...

Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our...

Registered Nurse – Case Manager Day shift, Monday to Friday, from 08:30 to 17:00. Every other weekend is required, with every weekend preferred. Holidays are also required. Assignment Details Contract length is 13 weeks.

Registered Nurse - Case Management Contract in Los Angeles, California - Ref #2929311 Description: Why Choose Greenstaff Medical US? Your Trusted Partner in Healthcare...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring a Utilization Review Nurse/ RN for Imaging/Commercial- Remote! Status: Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F.

Arkansas Blue Cross Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews for prior approvals, network exceptions, and various inpatient/outpatient cases. This role ensures medical necessity aligns with...

SCAN Health Insurance in the United States is seeking a Medical Management Specialist-RN to promote quality and cost-effective care under regulatory guidelines. Working under the Clinical Supervisor, the RN supports utilization management and case...

Job Description Responsibilities Review and evaluate electronic medical records of emergency department admissions and screen for medical necessity using InterQual or MCG criteria Apply evidence-based...

Concurrent Utilization Review (UR) Nurse The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews to ensure the medical necessity and appropriateness of healthcare services provided to members...

Clinical Case Manager Utilizes clinical expertise, discretion, and independent judgment in assessing/reassessing, facilitating care coordination, utilization management, and patient advocacy. Responsible for assuring medical...