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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...

Job Description Job Summary: Seeking an experienced in-patient Case Manager with Utilization Review expertise to assess and coordinate patient care, ensuring appropriate utilization and discharge planning. This role requires strong...

Job Title CRN - Case Review Nurse Job Description The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level. The CRN builds...

Resp & Qualifications PURPOSE: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the...

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

Job Description Travel Nurse - Case Management Epic Travel Staffing is hiring a Travel Nurse - Case Management. We`ll be your ticket to the travel RN - Case Manager job you`ll love with unparalleled recruiter support and...

Clinical Record Reviewer - Full-Time Days (Remote) Manages and supports quality and performance improvement by assisting staff to implement strategies that identify, prioritize, measure, and improve key clinical processes and outcomes.

Description We are seeking a highly organized and proactive Administrative Assistant III to provide administrative support to 4 to 6 inpatient units at Santa Monica UCLA Medical Center. As a member of the Nursing Administration...

Benefits: 401(k) 401(k) matching Bonus based on performance Company parties Dental insurance Free food & snacks Health insurance Opportunity for advancement Paid time off Parental...

Clinical Clearance Specialist (RN) Remote, United States Why Charlie Health? Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often,...

Description Mission Statement The Salvation Army, an international movement, is an evangelical part of the universal Christian church. Its message is based on the Bible. Its ministry is motivated by the love of God. Its...

RN - Case Manager Shift: 8H Days Start Date: 08/24/2026 End Date: 11/23/2026 Duration: 13 Week(s) Location: Burbank, CA Weekly Pay is estimated and does not include taxes, insurance, or other deductions...

Hours: FT, Mon-Fri 8:30-5p Under the direction of the Care Management Manager, the Health Coach functions as the primary nurse to provide both health coaching and case management services to members across the continuum of...

Nurse Manager Job Type: Permanent Position Urgency: Normal Offering Nursing Profession: Nurse Management Specialty: Nurse Manager OR Shift Details: Shift 08:00 AM - 04:00 PM Shifts Per Week: 5...

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...

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...

Specialised Part-Time Consulting Opportunity for Nursing Professionals We are sharing a specialised part-time consulting opportunity for nursing professionals experienced in patient care, clinical monitoring, medication administration,...

Your Role 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...

NeighborHealth Job Opportunity Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center! As one of the largest community health centers in the country, NeighborHealth is proud to serve the...

Registered Nurse (RN) for Utilization Management Team We are seeking a Registered Nurse (RN) to join our Utilization Management team. In this role, you will perform concurrent reviews, prior authorizations, medical necessity reviews,...

Remote Triage Nurse Billings, Montana firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on...

RN Case Manager SNP Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united...

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...

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

Triage Nurse firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual...