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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...

Registered Nurse (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

Details Client Name Dignity Health - California Hospital Medical Center Job Type Travel Offering Nursing Profession RN...

Overview Facilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS.

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...

NurseRemotely is seeking a licensed RN for a remote case management role with a Health Insurance client. You will design care plans, assess needs and coordinate services across various teams to ensure quality, cost-effective care.

A national healthcare recruiting firm is seeking remote workers fluent in Spanish for a role supporting HEDIS project management. Responsibilities include coordinating the collection and abstraction of medical records, participating in vendor...

To support clinical staff in a team environment, the full-time Utilization Review Coordinator will manage utilization review requests, verify and enter data into relevant systems, and respond to inquiries while working remotely.Key...

Job Title Pay Rate: $27.50 per hour Work Mode: Fully Remote Duration: September to February with possible extension Responsibilities: Work telephonically with claimants, physicians, employers, and customers to ensure...

description: Provides excellent patient care by assisting in the collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, physicians,...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* Job Summary: Reviews all medical (and other) documentation in claim files to answer the specific...

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...

Clinical Guide Part A The weekly schedule choice is either Monday - Friday 10am-7pm EST OR Tuesday - Saturday 9am-6pm EST A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team,...

Registered Nurse - Case Management - Travel | Torrance, California Estimated Weekly Pay: $1935.10 Start Date: 11/09/2026 | Duration: 13 Weeks Shift: 5 x...

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...

Details Client Name California Hospital Medical Center Job Type Travel Offering Nursing Profession Registered Nurse...

Provides direct nursing care including assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the...

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...

Parenteral Services Clinical RN Specialist The Parenteral Services Clinical RN Specialist provides clinical support to the Parenteral Services team through advanced nursing expertise, education, care coordination, and operational...

RN Case Manager – Workers' Compensation Salary Range: $110,000 – $115,000 per year Location: Los Angeles, CA Field-Based / Local Travel Required Position Summary RCM Healthcare Services is recruiting an experienced Field Nurse...

Location This is a hybrid role. Applicants must be able to commute to or travel to Mitchell and Dougherty counties, GA, when required. About Us The Columbus Organization is a nationally...

Job Description ProMed Staffing Resources is seeking several Registered Nurses (RN) with 2 years of recent Case Management experience and we're offering amazing benefits and...

Certified Nursing Assistant (CNA) Coordinator Professional ExpertGlendale Community College is currently accepting applications for a Certified Nursing Assistant (CNA) Coordinator Professional Expert.Examples of DutiesProvides support in managing...

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...

UCI Health Case Manager UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health...