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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,...

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...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

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...

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...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

*This role will require the successful candidate to work the shift of Monday to Friday, 1pm to 10pm Central (2pm to 11pm Eastern). The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This...

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

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...

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...

Registered Nurse (RN) For Utilization Management Team We are seeking a Registered Nurse (RN) to join our Utilization Management team. In this role, you will perform concurrent reviews, prior authorizations, medical necessity reviews,...

Concurrent Review Registered Nurse (RN) Location: Fully remote. Our client is seeking an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role, you will perform concurrent...

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:...

Job Opportunity Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the...

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...

Alliance Liaison If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where...

Utilization Management Inpatient Clinical Specialist Work from home within Washington, Oregon, Idaho or Utah. Preference will be given to current employees and candidates who reside in Idaho and Utah. Build a career with purpose.

Join Gainwell It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career...

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded...

Job Summary: The LVN Case Manager works under the direction of an RN following assessment, planning, facilitation and advocacy, which are achieved through collaboration with the client and other health care...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

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...

Concurrent Utilization Review (UR) Nurse NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health...

Lead complex care management for members with primarily physical health needs through comprehensive assessments, person-centered care planning, coordination, education, and ongoing monitoring. Support PHCO Case Management and collaborate with...