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Mercor connects elite creative and technical talent with leading AI research labs. A remote Utilisation Management leader role is available, requiring RN licensure and physician-advisor experience. Contract position with high-level...

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...

Admissions Nurse Do you enjoy being at the beginning of the journey? The Admissions Nurse is responsible for establishing and maintaining positive relationships with customers and referral sources within the community. The Admissions RN...

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...

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...

Summary This is an OPEN CONTINUOUS ANNOUNCEMENT & will remain open until 10/29/2026 or until filled. Qualified applicants will be referred to hiring managers at regular intervals. Your application will remain active for 3 months.

Overview HarmonyCares is a leading national value-based provider of in-home primary care services for people with complex healthcare needs. Headquartered out of Troy, Michigan, HarmonyCares operates home-based primary care...

Job Title Pay Rate: $27.50 per hour Work Mode: Fully Remote Duration: September to February with possible extension Responsibilities: Work telephonically with claimants, physicians, employers, and customers to ensure...

Ambulatory Care Coordinator RN Could you be our next Ambulatory Care Coordinator RN at Main Line HealthCare? Why work as a Ambulatory Care Coordinator RN with Main Line Health? Make an Impact! Coordinating the care of a patient's...

This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

IV Infusion Specialist Assessment Nurse The IV Infusion Specialist Assessment Nurse is responsible for identifying current and future patient care needs; being able to recognize normal versus abnormal body physiology. The role requires...

Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00...

Location This is a hybrid role. Applicants must be able to commute to or travel to Mitchell and Dougherty counties, GA, when required. About Us The Columbus Organization is a nationally...

Job Title Day to Day Responsibilities Research and design treatment/care plans to promote quality of care, cost-effective health care services based on medical necessity complying with contract for each appropriate plan type.

Chronic Care Coordinator Location: MICHIGAN - 100% REMOTE (NOT A COMPACT STATE) Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing...

Managing patients' specialized needs remotely, the full-time Nurse Care Manager will take ownership of patients with complex chronic conditions, collaborating with healthcare providers to develop comprehensive nursing care plans aimed at...

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure...

Job Description Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News &...

Overview Facilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS.

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...

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...

Description Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the patient's placement to be at the most appropriate...

Are You Ready to lead in Healthcare? We are currently seeking a Full-Time Case Manager(LPN/LVN) to join our outstanding healthcare team! Salary Range: $83,203-$93,936 per year We are passionate...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Hospice Admissions Nurse Peoples Health Services is the only family-owned, locally governed Hospice and Home Health provider in the Florida Panhandle. We believe that when we take care of the people who care for our patients, everyone...