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About IntusCare IntusCare is the only end-to-end technology ecosystem built specifically for PACE (Programs of All-Inclusive Care for the Elderly) and similar coordinated care models. We help our customers deliver exceptional...

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the...

Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform-bringing health plan administration, holistic...

Molina Healthcare of California is hiring a Transition of Care Coach LVN/LPN . This role is remote; however, candidates must have a valid and unrestricted California LVN/LPN licensure. The hours will be Monday through Friday from...

Job Summary: We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, or Operating Room to perform utilization review duties. The Registered...

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 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...

Humana is seeking a Telephonic Care Manager to support a remote case management program. You will coordinate care across sites and levels of care, leveraging resources to prevent readmissions and ensure integrated, compliant care plans for...

Registered Nurse The registered nurse plans, organizes and directs home care services and is experienced in nursing, with emphasis on community health education/experience. The professional nurse builds from the resources of the community...

Job Description WHAT YOU'LL DO As an admissions nurse at VITAS Healthcare, you will be the first face of hospice for patients and families. Your meeting will likely be the first time they...

CareHarmony is seeking a licensed practical nurse to join as a remote Intake Coordinator in a full‑time role. The position supports value-based care management by coordinating resources for patients and conducting preliminary health assessments...

Clinical Research Nurse-BSN Clinical Research Nurse 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...

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...

Supportive Housing Case Manager (Ages 18–25)The Supportive Housing Case Manager (Ages 18–25) supports young adults in securing and keeping stable housing while building life skills and independence. Using a positive, youth-centered approach,...

Centene Corporation is seeking an RN- or LPN/LVN-licensed nurse to serve as a liaison for statewide appeals, fair hearings, and external reviews. This remote role supports Eastern and Central time zones with a standard 8–5 schedule and requires...

The Department of Family Medicine of the Keck School of Medicine of USC provides care for every member of the family, across generations and over lifetimes. We aim to enhance the quality of life for underserved and vulnerable patients while...

RN Care Coordinator Care Coordination Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

AltaMed Nurse (RN) Case Manager/Care Coordination Team Leader If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed –...

Job Description Responsible for collaborating with healthcare providers and physicians for problem solving, prioritizing and facilitating patient care objectives, the coordination and development of staff education, and...

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:...

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...

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

Utilization Management Nurse (RN) (Temporary) Remote in California We believe every candidate deserves thoughtful consideration. That's why we do not use AI or automated systems to review applications. Every application is reviewed...