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Nurse Care Manager - Telephonic (Local Remote) Tandigm Health, a transformational leader in population health management, is looking for a Nurse Care Manager - Telephonic in the greater Philadelphia area. We offer a competitive...

Clinical Guide A bit about this role: As a Clinical Guide on our Outpatient Utilization Management team, you'll have the opportunity to make a difference in the lives of our members. You'll be responsible for clinical review of...

Description & Requirements Maximus is seeking a Registered Nurse, Clinical Assessor to join our growing team. As a Nurse Assessor, you will conduct person-centered assessments in accordance with contract directives, company processes, and...

Description Patient Business Services Provide clinical review, audit, analytical, and quality improvement support for utilization management, medical necessity determinations, and denial prevention...

RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable...

Kaiser Permanente in Los Angeles is seeking an experienced RN for a case management role within a multidisciplinary team. You will assess patient needs, develop individualized care plans, and coordinate access to services across physicians,...

Utilization Review Specialist (RN) – Work From Home (Florida-Based Candidates Only)Concierge Home Care | Work From Home Opportunity – Must Reside in Florida At Concierge Home Care, we are growing and looking for an experienced...

Become a part of our caring community As a Clinical Manager at CenterWell Home Health, reporting to the Branch Director, you support a team of dedicated clinicians who deliver compassionate, high quality care in the home setting. By guiding clinical...

BlueCross BlueShield of South Carolina is hiring a Managed Care Coordinator II - Utilization Management. The role reviews clinical criteria to determine medical necessity and coordinates care management for members. The position is full...

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform both inpatient and outpatient...

Alignment Health is seeking a Telephonic RN Case Manager for the SNP program, fully remote within the U.S. The role focuses on guiding Medicare Advantage SNP members through their care journeys from home, with emphasis on closing gaps in care.

Providence California Regional Services seeks an RN Care Manager for a remote, full-time role. The position supports patient-centered care management and appeals coordination, focusing on reimbursement for services in the PH&S network.

RN Hospice Case Manager We are hiring a full-time RN Hospice Case Manager to join the Athena Home Health & Hospice team in the Torrington area! This position is on-the-road covering Litchfield County and western Hartford County.

A leading health service provider in Kentucky is seeking experienced Registered Nurses for the Field Care Manager role. Nurses will conduct non-clinical, in-home assessments and manage their own schedules. The position offers a competitive salary,...

OverviewJobs for Humanity is partnering with CEDARS‑SINAI to build an inclusive and just employment ecosystem. We prioritize individuals from diverse communities including Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard...

Clinical Appeals Nurse (RN) | Remote | Contract Walker Healthforce is seeking a Clinical Appeals Nurse (RN) with 2+ years of clinical nursing experience to provide clinical review and...

APGUARD HOSPICE LLC is seeking a dedicated RN Case Manager to join our remote hospice team. The role focuses on coordinating patient care across settings, optimizing outcomes, and guiding families through palliative care with expert nursing...

Included Health seeks passionate California-Based Nurse Care Managers for their Care and Case Management team. You will coordinate and deliver patient-centered care, helping members navigate their healthcare journey while ensuring they receive...

Utilization Review RN - Remote This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review...

Research Nurse (Per Diem) - Greater Portland, OR areaIllingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device industries. These include mobile research...

HealthMap Solutions is seeking a Registered Nurse, Care Navigator/Case Manager to lead case management for kidney health, coordinating care and improving outcomes for a mixed caseload. You will document in Compass, perform health screenings,...

Joining a dedicated team, the remote full-time Oklahoma RN Case Manager will manage utilization review processes, coordinate patient care transitions, and develop discharge plans while working days and every other weekend.Key...

Nascentia Health is seeking a Care Manager to provide care management for health plan members, creating PCSPs, coordinating services, and documenting care per standards under supervision. This is a remote role with Monday–Friday, 8:00 AM–4:30...

About This Role The Case Management Specialist RN - Oncology works collaboratively with a panel of physicians to manage patients' specialized needs, focusing on assessment and development of care management plans. This role is ideal for...

Mission Healthcare, located in seven states, is the largest home health and hospice company in the western United States. We have a critical mission-to take care of our people. We provide a comprehensive array of services that meet the needs of...