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Clinical Appeals and Grievances Specialist Will this role be fully remote? Yes. Are there any specific locations the candidates should be in (i.e., do they need to live in IL)? No but must have CA license. Work Schedule/Shift & Time Zone:...

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...

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...

RN Case Manager PAY: $ 2922 weekly gross for 36 hr W2: $ 36.30/hr Weekly stipend: $1470 Position: RN Case Manager Facility Name: Providence Saint Mary Medical Center Location: Burbank, CA 91505 Shift: Day 5x8-Hour (08:00 -...

Job Summary and Responsibilities As our RN Care Coordinator, you will be a central figure in patient care, seamlessly navigating the healthcare journey to achieve optimal outcomes and an exceptional patient...

Collaborative Practice Nurse (CPN) Blue Ridge Cancer Care is seeking an experienced and highly motivated Collaborative Practice Nurse (CPN) to support oncology patients across the continuum of care. The CPN serves as a clinical resource...

Discharge Nurse II, RN Arcadia Office - Arcadia, CA 91007; Huntington Beach Office - Huntington Beach, CA 92647 Overview Salary Range $81,500.00 - $100,000.00 Salary Position Type Full Time Description This...

Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

Benefits: 401(k) 401(k) matching Dental insurance Health insurance Vision insurance Wellness resources Company parties Opportunity for advancement Paid time off Parental...

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...

Medical Management And Health Education Program Coordinator Fully Remote JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs.

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...

Care Management Coordinator/RN Location: 100% Remote Duration: 3+ Months (Possible FT conversion) General Summary: Under the direction of a designated Care Management and Coordination Supervisor, performs telephonic or onsite...

Collaborative Practice Nurse (CPN) Blue Ridge Cancer Care is seeking an experienced and highly motivated Collaborative Practice Nurse (CPN) to support oncology patients across the continuum of care. The CPN serves as a clinical resource...

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...

RN Case Manager Position Summary: RN Case Manager Position Duties: Care Coordination / Continuum of Care / Discharge Planning / Patient Focus and Care Plans Minimum Required Qualifications: CA RN license; BLS; LA City Fire &...

PIH Health in Los Angeles is seeking an RN Peer Review Analyst responsible for retrospective medical record reviews, data compilation to validate quality and accuracy of documentation, and auditing charts for admission/continued stay. You will...

Trustaff is seeking a travel nurse RN Clinic for a travel nursing job in Los Angeles, California. Job Description & Requirements Specialty: Clinic Discipline: RN Start Date: 11/02/2026...

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...

Your job is more than a job You overthink every care option and scenario because, as a Care Manager, you're the hub of your patient's case management and care plan. You assure quality through the continuum of care, collaborate with members...

RadHealth+ is seeking a travel nurse RN Utilization Review for a travel nursing job in Torrance, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start...

PerDiem Nurse - Phase I Infusion Clinic Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope's...

Utilization Review Nurse Auditor Fully Remote • Mount Laurel, NJ 08054 Salary Range $33.00 - $46.00 Hourly Position Type Full Time Travel Percentage 10% ExamWorks is looking for a Utilization Review Nurse Auditor to join...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

Case Management Support To provide support and facilitate care for members who require case management. To work collaboratively with the Health Plan and Hospital Case Management Departments to facilitate services. To collaborate with the...