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UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To:...

Position: #710291 Program: Case Management Department: Health Services Reports To: Supervisor of Nurse Case Management Services Shift Differential Premium: $1.75 per hour for hours worked between 6pm-6am...

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...

University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and...

Job Description Join a purpose-driven team in downtown Los Angeles as a Complex Care Registered Nurse (RN) supporting the PACE Program. We're seeking a dedicated nurse who is committed to providing compassionate, high-quality,...

Overview Position Type: Full time Job Title: Care Review Clinician I Location: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH,...

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...

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,...

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...

Clinical Appeals Reviewer Responsible for the timely review and resolution of clinical appeals submitted by providers and members across all lines of business. Communicates appeal determinations in accordance with regulatory requirements...

Registered Nurse Position Duties Description POSITION DESCRIPTION: Provide professional nursing services to individuals with developmental disabilities. Services may include, but are not limited to, nursing interventions and...

Job Details: Job Location: Curawest LLC - Denver, CO, Position Type: Full Time, Education Level: High School Diploma or Equivalent, Salary Range: $55000.00 - $60000.00Salary, Travel Percentage: None, Job Shift: Day (First Shift), POSITION PURPOSE:...

NICU Registered Nurse Case Manager At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for...

A leading health service provider in Kentucky is seeking experienced Registered Nurses for the Field Care Manager role. Nurses will conduct non-clinical, in-home assessments and manage their own schedules. The position offers a competitive salary,...

Title: QIC Part A Nurse Consultant Location: Remote Duration: 6 months Shift time: Hours; 8:30 am - 5:00 pm EST (Monday - Friday) Pay rate: 30.00/hr Job Description Essential Duties and...

UBC is seeking a Telephonic LPN for their call center in a remote US setting. The role delivers telephonic nursing support, patient education, and resource referrals for client-funded programs. Requirements include an associate degree in...

About the Job SUMMARY The Clinic RN will demonstrate Christ-like behavior and attitude in all job duties and responsibilities, as well as adhering to policies, procedures, standards and regulations of the RN...

Care Manager, RN Shriners Children's is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

Managing the day-to-day operations of the Maternity Case Management department, the fully remote Registered Nurse Case Management Supervisor will oversee staff, adjust work queues, and support team members while ensuring adherence to department...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

Job Description: The Hospitalist Coordinator RN plays a vital role in supporting the delivery of safe, efficient, and patient-centered care for hospitalized patients at St. Mary's Regional Hospital. Serving as a key partner to physicians, care...

About This Role The Case Management Utilization RN works collaboratively with physicians to coordinate patient admissions and continued stays, ensuring appropriate levels of care. This role is ideal for experienced nurses who excel in a fast-paced...

Kaiser Permanente is seeking a registered nurse with utilization management experience to oversee skilled and custodial patient care in rehabilitation SNFs. The role focuses on benefits checks, discharge management, and coordinating a chronic...

Employment Type: Full timeShift: Day Shift Description: This is not a remote position The licensed Registered Nurse (RN) plans & provides...