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Clinical Appeals Nurse We are seeking an experienced Clinical Appeals Nurse to support the appeal and grievance processes by analyzing and responding to adverse coverage decisions. This role involves clinical judgment, regulatory...

Description Research Nurse (Per Diem) - Oahu, Hawaii Illingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device industries. These include...

Nurse Case ManagerUnder the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, acting as a resource to staff and physicians in resource efficiencies and...

Job Description SUMMARY: The Nurse Case Manager (NCM) is responsible for applying medical knowledge in reviewing workers' compensation claims to assess, evaluate, plan, implement and oversee the...

Workers' Compensation Telephonic Nurse Case Manager The Workers' Compensation Telephonic Nurse Case Manager is responsible for evaluating and expediting appropriate, cost-effective medical treatment of injured employees with the goal of...

Utilization Management Nurse Join us in our mission to transform healthcare! NirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

PRN Assessment Nurse The PRN Assessment Nurse is responsible for identifying current and future patient care needs; being able to recognize normal versus abnormal body physiology. The role requires critical thinking, attention to detail...

Job Details This outstanding unit is looking for the right Case Manager RN to join their team of compassionate and driven health care professionals. Join this highly motivated team of caregivers and enjoy a challenging and welcoming...

Duration: 4 months contract (with possible extension) Job Description: The Clinical Reviewer, Inpatient RN, is a licensed professional that is expected to function independently in her / his role and...

Registered Nurse RN Case Manager Title: Registered Nurse RN Case Manager Company: Great Nurses Home Care Reports to: Manager of Hospice Operations Location: Burbank, CA About Great Nurses Home Care Great...

Shearwater Health Registered Nurse, Utilization Review At Shearwater Health, we know that better patient outcomes are never achieved alone – especially when there aren't enough hands to deliver care. That's why we've built something...

Staff Nurse Case Manager 10/12/26 08:00 AM-04:30 PM Day Shift, 8-4:30PM, T-Sat, 40 hrs/week. No on call. Must have an RN CM certification. Looking for staff with IP CM experience, preferred staff that are used to strike force for KP or...

Posting Date 08/13/2026 17815 Ventura BlvdSuite 100, Encino, California, 913163600, United States of America DaVita is hiring a Clinical Coordinator (RN) to lead outpatient dialysis care for patients with end-stage renal disease. In...

Infusion Nurse II With the nation's largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the...

Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

JOB REQUIREMENTS: -Experience: 3 years acute care case manager experience -CA RN License -Certs: BLS -**FLU VACCINE (no exemptions)** Flu season starts September -Special Requirements: EPIC highly preferred. Due to nature of...

Join us as we transform immunology and deliver medicines that help autoimmune patients get their lives back. argenx is preparing for multi-dimensional expansion to reach more patients through a rich pipeline of differentiated assets, led by...

Job Title Health Information Management Job Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members.

Job Opportunity Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the...

Description Under supportive supervision, the Case Management Nurse II position supports the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of...

Case Management Nurse II Under supportive supervision, the Case Management Nurse II position supports the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of...

LPN/LVN - LTC Shift: 8H Days Start Date: 09/14/2026 End Date: 12/14/2026 Duration: 13 Week(s) Location: Los Angeles, CA Weekly Pay is estimated and does not include taxes, insurance, or other deductions...

Apply Now Certification: Registered Nurse Specialty: Case Manager Location: Los Angeles, California Jobs Available: 1 Job Type:...

Nurse - Clinical Review The Clinical Review Nurse makes prospective medical necessity determinations on prior authorization requests for HealthHelp's specialty programs, including Diagnostic Imaging, Cardiology, Musculoskeletal, Physical...

Job Title This is a remote, PRN 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...