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Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

Job Description The Clinical Documentation Integrity Specialist II(CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of provider-based...

Requisition Details GENERAL REQUISITION INFORMATION EEO Statement: UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and...

Registered Nurse – Care Management (Remote) (Day Schedule) United States Job Title: Registered Nurse – Care Management (Day Schedule) Location: 100% Remote - United States Employment...

About this role We are looking for a Patient Care Coordinator with an active LVN license and 2+ years of experience in healthcare startups to join a fast-growing surgical navigation company that's redefining how self-insured employers...

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...

Clinical Appeals Specialist The Clinical Appeals Specialist completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Specialist utilizes...

Neolytix is seeking a remote, full-time Clinical Operations reviewer in the United States. The role leverages a nursing background to assess documentation for authorization, utilization review, and payer workflows. You will manage...

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...

Utilization Management Nurse Join us in our mission to transform healthcare! NirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

The University of Miami UHealth Department of UMHC-SCCC Business Operations has an exciting opportunity for a full time Case Manager RN. The incumbent coordinates the overall interdisciplinary plan of care for patients, from admission to...

Grievance & Appeals Nurse, RN 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 experience! Reporting to the...

Utilization Management Nurse (RN) (Temporary) Remote in California We believe every candidate deserves thoughtful consideration. That's why we do not use AI or automated systems to review applications. Every application is reviewed...

Job Requirements Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need...

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...

UnitedHealth Group seeks a Registered Nurse, Case Manager to perform telephonic nursing assessments, develop care plans, and coordinate care and benefits for patients. This role supports remote work and aims to improve patient outcomes from a...

A virtual health treatment company is seeking a Family Nurse Practitioner to provide care for patients with eating disorders through their telehealth platform. This position requires managing a high patient case-load, conducting assessments, and...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

Overview: Dane Street is seeking highly motivated candidates to join our team as a Clinical (RN) QA Specialist, specializing in Disability. We offer an exciting work environment, competitive compensation, and strong growth...

A leading staffing company is seeking a remote Case Manager RN to coordinate care for a diverse health plan population. Applicants must hold an active nursing license in Michigan and have at least three years of clinical experience, alongside...

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...

Job Title This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values guide...

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...

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...

Nurse Care Manager The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while...