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Renown Health is seeking a Utilization Management RN to apply medical necessity criteria for prospective and concurrent reviews. You will work with an interdisciplinary team to ensure medically necessary, cost-effective care at the appropriate...

Namely is looking for Nurse Care Managers based in California to join their Care and Case Management team. The role involves guiding members through complex healthcare situations and developing cohesive care plans. The ideal candidate will...

Job Title Pay Rate: $27.50 per hour Work Mode: Fully Remote Duration: September to February with possible extension Responsibilities: Work telephonically with claimants, physicians, employers, and customers to ensure...

Yoh is seeking a Utilization Management Nurse Coordinator (RN or LVN) for a 6+ month remote contract with a managed care client based in Northern California. Training occurs onsite in Fairfield or Redding for three weeks, then transitions to fully...

RN Care Coordinator Care Coordination Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest...

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...

Salary: $82,555.20 - $123,822.40 Annually Location : Chaska Government Center, MN Job Type: Full-Time Remote Employment: Flexible/Hybrid Job Number:...

Scope: The Case Manager Assistant assists the RN Case Manager in performing necessary functions using the Case Management process in order to meet the needs of MedWatch, LLC customers and consumers. This includes, but is not limited to,...

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...

Supervisor Utilization Management The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization Management department in order to assure that utilization management...

CVS Health is seeking an experienced Registered Nurse to support 24/7 Utilization Management, reviewing cases, assessing medical necessity, and coordinating care from a remote home office. Candidates must hold an active RN license and have at...

Job Description Provides direct nursing services and case management related to infusion therapy for patients in the home, clinic, or alternate living site. This is accomplished through collaboration and coordination with...

Become a part of our caring community The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the...

Alora Supports Missouri LLC is seeking a Regional Manager RN to provide clinical oversight and operational leadership across the Southern Missouri region. The role blends hands-on nursing responsibilities with strategic management, requiring a...

At Amped HQ, we're on a mission to connect top talent with opportunities that drive real impact. We're constantly expanding our global network, seeking the best and brightest to join our team and contribute to our partners' success. With...

Guidehealth in the United States seeks an experienced RN Case Manager to work remotely with Illinois licensure. You will oversee member management, promote wellness, and support cost-effective care within a value-based care framework.

Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...

Job SummaryWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical...

Details Client Name WelbeHealth - North Hollywood Job Type Travel Offering Nursing Profession RN Specialty...

Connect America is seeking a Remote Care Nurse II to deliver high-quality nursing care to patients in a remote setting via telehealth. You will perform remote assessments, develop care plans, and coordinate with a multidisciplinary team to improve...

Job Title Employment Type: Full time Shift: Rotating Shift Description: This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint...

Inland Empire Health Plan is seeking a Claims Review Nurse, LVN to perform timely medical reviews of facility and professional claims. You will identify improvements in the UM/Claims interface and support clinical determinations under supervision,...

Administrative Assistant - Cancer Registry (Remote) Healthcare Admin Jobs has an excellent opportunity available within our Administration Department. This is a remote position. If you are looking for challenging work and meaningful...

Grow HealthyIf you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed – it's nurtured, celebrated, and promoted, allowing you to...

Pyramid Consulting, Inc. is seeking an experienced Clinical - Care Manager (RN) for a 6+ month contract with remote work options in Florida. This role involves steady telephonic outreach, member assessments, and care coordination for a caseload of...