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Job Description A bit about this role: Under the guidance of the Manager, Clinical Services and Escalations the Clinical Nurse Specialist will function in a very cross functional, diverse capacity working with multiple...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

Position Summary The Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective...

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Los Angeles, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days...

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...

Enlyte is seeking a Field Case Manager who will collaborate with physicians, employers, and patients to design effective treatment plans and facilitate safe return-to-work after injuries or incidents. This full-time, work-from-home role requires...

Acentra Health is seeking a Clinical Review Advisor to review medical records, prepare cases for physician review, and ensure compliance with State Medicaid policies. The role is remote within the U.S. with standard M-F hours; the first day...

Outpatient Case Manager (RN/LVN) Recruiting on behalf of a leading healthcare organization in Southern California About the Opportunity Vivo HealthStaff is proud to partner with our client, a...

Utilization Management Nurse Specialist RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary...

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.

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.

Humana Care Support is seeking a Telephonic Registered Nurse to act as a Care Manager. You will assess, plan, coordinate, and monitor care for Medicare members remotely, helping them stay independent at home. The role requires an active RN...

Benefits: 401(k) Competitive salary Dental insurance Health insurance Full-Time Hospice RN Case Manager Position Summary We are seeking a compassionate and experienced Hospice Registered Nurse (RN) Case...

Immediate Hire for Hospice RN Case Manager Immediate hire for Hospice RN Case Manager to join our Hospice Team! We provide high-quality, compassionate care focus on encouraging independence in the comfort and security of our patient...

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...

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.

A leading healthcare provider in California is seeking a Lead Case Manager to enhance patient management and ensure quality care. The role involves conducting audits, staffing adjustments, and training new hires in an inclusive and supportive...

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...

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...

To support injured employees in their recovery, the full-time RN Telephonic Case Manager will work remotely, conducting clinical assessments, coordinating medical services, and advocating for effective treatment while leveraging their nursing...

Join Silverado Hospice LA Silverado Hospice LA covering our Torrance and surrounding areas and be part of a nationally recognized team ranked in the top 10 nationwide by Fortune Magazine's Best Workplaces in Aging Services™. Since 1997,...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $142,166.00 (Max.) Established in...

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...