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Care Manager Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will...

Registered Nurse Beverly Hills, CA Home Health Registered Nurse (RN) – Per Diem | West LA area Territory: West LA & Surrounding areas Schedule: Per Diem / PRN (Flexible Scheduling) Now Hiring: Home Health RN Jobs...

Your Future Role At A Glance Location: Remote Facility: Ascension Saint Thomas Department: Utilization Management Schedule: Full-Time | Days Salary Range: $70,699.20 - $133,078.40 per year Life At...

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...

Job Title Location: 100% Remote – Any US State Shift: Fri-Sat-Sun-Mon 8:30 am – 6 pm CST Overtime may be required and Holidays are required Duration: 12months Job Profile Summary: Will be working with the IL and MI Medicaid...

Job Opportunity Title RN Date Opened 03/18/2026 Job Type Local/Travel Contract Industry Health Care Work Experience 1+ year City Northridge State/Province California Country United States...

Site: Mass General Brigham Community Physicians, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a...

We are hiring an Appeals & Grievance Nurse Analyst at BCBST! In this role, you will review and process appeals submitted by members and providers, ensuring timely and accurate resolution in compliance with CMS, Medicare, and TennCare...

Nurse Care Manager - Telephonic (Local Remote) Tandigm Health, a transformational leader in population health management, is looking for a Nurse Care Manager - Telephonic in the greater Philadelphia area. We offer a competitive...

Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...

At Caregenix, we are committed to delivering exceptional, value-based care. Our team lives by the iCARE values-Integrity, Compassion, Accountability, Respect, and Excellence-in everything we do. If you are passionate about improving patient...

RN - Utilization Management ID 2026-25367 Category Registered Nurse specialties - Case Manager Facility Nationwide - California Job Description Spectrum Healthcare Resources has...

Job Requirements Virtual Nurse- Centralized Nursing Services Spartanburg Regional Healthcare System is implementing an onsite Virtual Nursing Program utilizing virtual care equipment and technology.

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 level of care...

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...

Remote-Care Management Coordinator RN needed for a contract (3 months) opportunity with Yoh's client located in Philadelphia or surrounding PA area. This is s work from home position.

Utilization Review Case ManagerUnder 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...

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 PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory...

Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of...

Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

Enhanced Care Management Lead Care ManagerThis position reports to the Enhanced Care Management (ECM) Program Manager this position provides support to the ECM Program to ensure engagement, enrollment and follow up on members related to the ECM as...

Join Vynca Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs. We're more than just a team; we're a close-knit community. Our shared commitment to caring for each other and...

Nurse - Clinical Review Performs utilization review of cases to determine if the request meets medical necessity criteria in accordance with medical policies agreed upon with the Client and any applicable governing body. Facilitates...