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As a Care Coordinator, you are responsible for providing care coordination for Medicaid, Medicare Advantage, and/or Dual Eligible Special Needs Plan (DSNP) members. You will create a positive experience for members by building trusted...

Medical Review Specialist Scope: The Medical Review Specialist is a Registered Nurse who conducts the Utilization Review process by obtaining medical information and confirming the medical necessity of hospital admissions and/or...

Federal Healthcare Risk Management Nurse (DHA CQM Program) Tanaq Management Services (TMS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture,...

RN Utilization Mgmt Full-Time Day POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include: the e-TAR process, denials management,...

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...

Chronic Care Coordinator Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing problems before they happen for patients with two or more chronic...

Join the Team at Moorings Park as a RN Case Manager in Home Health (Private Duty) Moorings Park is seeking a dedicated and talented Case Manager to join our team. The Private Duty RN Case Manager is...

The Inpatient Transfer Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified patients during an acute care episode. Assesses and develops a care plan in...

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...

Job Title Job Summary: Review clinical documentation within the medical record to ensure that all principal diagnosis, secondary diagnoses, and PCS procedures have been coded accurately and completely as well as certain abstract items in...

Are you a person who believes in providing great care? Do you believe in having a positive impact on other people's lives? Are you a team-player, quick-thinker, and ready to be a part of an organization that supports your growth?WHAT WE'RE ABOUTWe...

Job Type Full-time Description Skilled Nurse Reports to: Director of Nursing JOB DESCRIPTION: The Skilled Nurse (LPN) role requires a compassionate, detail-oriented, and clinically capable Licensed...

Clinical Success Director/Manager - Nursing As the Clinical Success Director/Manager - Nursing, you will be at the forefront of defining, launching, and growing our generative AI platform for nurses. Your work will directly contribute to...

Mission Statement The Salvation Army, an international movement, is an evangelical part of the universal Christian church. Its message is based on the Bible. Its ministry is motivated by the love of God. Its mission is to...

Overview Monterey Park Hospital, a 101-acute care facility located in the San Gabriel Valley of Los Angeles County, is seeking a Case Manager RN or LVN for our Utilization Review Department. This is a per diem, 8-hour variable shifts position...

Denials Case Manager, RN The Denials Case Manager, RN appeals all denials using InterQual criteria and medical necessity. Collaboratively works with all members of the revenue cycle team and all types of payers to resolve denials,...

About the Opportunity We are seeking an experienced Case Management RN to coordinate patient care, discharge planning, and utilization review in a hospital setting. This role is ideal for nurses who enjoy...

How you'll change lives...

Registered Nurse If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional environment where your talent contributes to our competitive edge, Liberty Mutual Insurance has the opportunity for you.

Case Manager We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate...

Utilization Management Program Manager-RN Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products...

Description Who we are Founded in 1999 and headquartered in Central Ohio, we're a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity...

Job Description Job Description Date posted: March 9, 2026 Pay: $62,000.00 - $65,000.00 per year Job description: POSITION SUMMARY: Perform duties that require knowledge, skills, and abilities as a licensed professional Nurse (LPN). Assists the...

Telephonic Nurse Case Manager We are currently seeking an experienced Telephonic Nurse Case Manager (RN) to support workers' compensation cases through remote care coordination and telephonic case management services. This is a flexible...

About Abby Care: Powering the Future of Care at Home for All of America Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever.