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Utilization Management Nurse Specialist RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary...

Job Description Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual,...

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...

Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people...

Peer Review RN 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 leaders and...

Job Description The Case Manager Care Coordinator coordinates the care and service of patient populations from admission through discharge. The Care Coordinator clinically assesses, plans, implements, coordinates, monitors,...

About the Job All Care Home Health Provider is committed to caring. Serving the community for 30 years, we help educate our nurses with continuous clinical skills training for your home care career advantage. About the...

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...

Registered Nurse-Patient Centered Home Care South Carolina, South Carolina The Transition Care Nurse (RN) promotes safe transitions across the care continuum by completing telephonic outreach to patients discharged from the...

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

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...

Elevate Patient Financial Solutions has an exciting career opportunity available as a Nurse Auditor. This position will be a remote based role. The Full Time schedule for this role will be Monday through Friday 8 AM to 5 PM.

Discover Vanderbilt Health: With eight hospitals and over 180 clinics, we are the region's largest comprehensive academic health system. Vanderbilt Health has a long tradition of providing world-class care to the people of the Mid-South,...

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...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

Job Profile Summary Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's...

Employment Type: Full timeShift: Day Shift Description: Purpose Work Remote Position The Nursing Support (NS) colleague...

Cunningham Children's Home in Urbana, IL seeks a Nurse Case Manager to support residential programs serving youth with emotional and physical care needs. Responsibilities include medical case management, screenings, education, counseling, and...

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...

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...

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...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Join Our Innovative Company Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that...

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.

Job Title: Infusion Registered Nurse (RN) Location: Pasadena, CA (Surrounding areas) Job Type: Per-diem Position Overview We are seeking a skilled and detail-oriented Infusion Registered Nurse (RN) with strong vascular access...