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Job Description Responsibilities Review and evaluate electronic medical records of emergency department admissions and screen for medical necessity using InterQual or MCG criteria Apply evidence-based...

Overview What you can expect! 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...

Acentra Health is seeking a Case Manager (LPN or RN) to join our growing team. This remote role requires residence in Oregon and focuses on providing coordinated, patient-centered care to beneficiaries across the state. You will coordinate...

UCLA Health Advanced Practice Nurse Work Location: Santa Monica, CA, USA Work Schedule 4-day 10-hour shifts, 7:00am-5:30pm; may include weekends and holidays Salary Range: $68.81 - 88.99 Hourly Employment Type 2 - Staff:...

Hospice Registered Nurse Case Manager Location: Central LA (need to be willing to commute) Lead with Compassion & Excellence in Hospice Care Are you an experienced Hospice RN who thrives in leadership and is passionate about...

Find your calling at Mercy! Position Details: Primary Care Nurse RN or LPN Mercy Clinic Primary Care - Quailbrook (OKC) Monday-Friday, 40 hours per week *This is a hybrid remote position. The person hired for this role will...

A Path of Care Preferred Pathways of Hugo, OK is hiring a full-time ADvantage Case Manager to serve Hugo and surrounding areas. The role involves in-home assessments, care planning, and ongoing monitoring to help members live safely at home.

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...

Industry: Private Employment Type: Full Time Work Hours: 8 Hours Locations: USA Scope The Medical Review Coordinator will perform her/his duties in accordance with MedWatch procedures, MedWatch review...

Details Client Name Providence Saint Joseph Medical Center - Burbank Job Type Travel Offering Nursing Profession RN...

Arkansas Blue Cross Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews for prior approvals, network exceptions, and various inpatient/outpatient cases. This role ensures medical necessity aligns with...

Back Manage Care Coordinator (RN) - Remote Healthcare Columbia , South Carolina Contract On-Site Oct 26, 2026 Manage Care Coordinator - RN Job at a Glance Title: Manage Care Coordinator...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring a Utilization Review Nurse/ RN for Imaging/Commercial- Remote! Status:...

Details Client Name PIH Health Downey Hospital Job Type Travel Offering Nursing Profession RN Specialty...

SCAN is seeking a part-time, telephonic care coordinator RN to support frail seniors in navigating the healthcare system and living independently. You will work with members remotely to assess needs, develop plans of care, and deliver health...

Why This Role Matters Every determination you make decides whether a member gets the care they need, when they need it. This role sits at the exact point where clinical judgment meets real-world impact, translating evidence-based criteria...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

A leading healthcare provider is seeking a Registered Nurse for their LTSS department in New York. This role involves providing case management services, evaluating medical services, and managing appeals for denied services. Candidates must...

RN - Case Manager Cure Healthcare is seeking a RN - Case Manager for positions in Sitka, Alaska. Current Alaska license and AHA BLS and ACLS required and additional certifications related to this specialty. To qualify for this travel...

External Case Manager - Inpatient Rehab (RN, PT, OT, SLP)Cal Rehab, a joint venture with Select Medical, UCLA, and Cedars SinaiFull‑time (Mon‑Fri 8 am‑5 pm, plus rotating weekends) in Los Angeles, CA.Base salary $80,000–$115,000...

Utilization Management Nurse Consultant (RN) 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...

SCAN Health Insurance in the United States is seeking a Medical Management Specialist-RN to promote quality and cost-effective care under regulatory guidelines. Working under the Clinical Supervisor, the RN supports utilization management and case...

Staff Builders is seeking a local contract nurse RN Case Management for a local contract nursing job in Glendale, California. Job Description & Requirements Specialty: Case Management Discipline: RN...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* Job Summary: Reviews all medical (and other) documentation in claim files to answer the specific...

RegisteredNurse-ReviewAnalyst|Remote|Contract...