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Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after...

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 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.

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.

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...

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.

Registered Nurse (RN) – Private Duty Nursing $40–$42/hour | 1:1 Pediatric Care | Flexible Scheduling | Cases Available Across Michigan Looking for an RN position where you can focus on one patient...

Company : Allegheny Health NetworkJob Description : GENERAL OVERVIEW: Responsible for obtaining insurance precertification/recertification, functioning as a liaison with...

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...

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...

Guidehealth is seeking a remote-based Care Manager (RN) to guide patients and families through complex health journeys. You will blend clinical expertise with holistic care, addressing medical, behavioral, and social needs while coordinating...

Description Bilingual Nurse Case Manager (RN) - Workers' Compensation Locations: Los Angelas, CA Salary: $100,000-$130,000 annually + Monthly Bonus...

Clinical Nurse, Medical Management/Utilization Management Saratoga Medical is hiring for a Clinical Nurse, Medical Management/Utilization Management in Falls Church, Virginia. Package includes competitive rate, paid time off and benefit...

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...

8 weeks. DAYS - 5x8 SCHEDULE: M-F - 8am to 4:30pm Care Coordinator inpatient. Must Be/Have: Experienced CM • a RN • Discharge planning assessment exp • Excellent UR • Psych social assessment skills • Acute hospital...

Centene is seeking an RN with strong appeal review experience to act as liaison for statewide appeals, fair hearings, and review organizations. This fully remote role supports members and providers while ensuring compliance with State and NCQA...

Nurse Advocate Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris...

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...

RN Care Manager *F/T Variable* Santa Monica, California Full Time RN Care Manager with our Care Management Team at our Cedars-Sinai Tarzana Medical Center in Tarzana, CA. This is a full-time position that will work 8-hour...

Care Management Team Member The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

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 & World Report's "Best Hospitals 2024-25" rankings, as well as placed...

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...

Job Description Are you ready to bring your clinical competencies to a world-class Medical Group known for the very highest clinical standards? Do you have a passion for the highest quality and patient satisfaction? Then...

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...

Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...