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Nurse Care Manager We're looking for Nurse Care Managers for our Care and Case Management team, who are passionate about caring for members holistically through their healthcare journey and ensuring needs are met with industry-leading...

About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors...

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...

New York Community Care is seeking a Pediatric RN Case Manager for our Brooklyn office. You will coordinate patient care, supervise clinical staff, and review cases to ensure timely and effective home health services. The role offers a...

Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $142,166.00 (Max.) Established in...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

Utilization Review RN - Remote This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review...

Job Title Case Management Nurse Job Description Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital,...

UnitedHealthcare is seeking an experienced RN to provide frontline education and guidance to members across the continuum of care. You will handle medical questions, coordinate care, and refer to internal programs while delivering compassionate,...

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 the better. Come build the health care system...

UnitedHealthcare is seeking an experienced registered nurse to join a frontline clinical resource program that educates and supports members about health management. The role emphasizes customer service, nursing judgment, and collaboration to...

OverviewJobs for Humanity is partnering with CEDARS‑SINAI to build an inclusive and just employment ecosystem. We prioritize individuals from diverse communities including Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard...

Registered Nurse – Care Management (Remote) (Day Schedule) United States Job Title: Registered Nurse – Care Management (Day Schedule) Location: 100% Remote - United States Employment...

RN Care Coordinator Care Coordination Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest...

HealthMap Solutions is seeking a Registered Nurse, Care Navigator/Case Manager to lead case management for kidney health, coordinating care and improving outcomes for a mixed caseload. You will document in Compass, perform health screenings,...

Included Health is seeking a Maternity Nurse Care Manager to join our Care and Case Management team. This telephonic, remote role supports patients through pregnancy from preconception to postpartum with holistic, evidence-based care. You...

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...

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...

JOB DESCRIPTION Job Summary Work Location: California - Ability to work remote, but selected candidate must reside in the state of California. This position requires California RN Licensure. Candidates must...

Description Patient Business Services Provide clinical review, audit, analytical, and quality improvement support for utilization management, medical necessity determinations, and denial prevention...

OU Health is seeking a Case Manager, RN - Utilization Review (PRN) to evaluate medical necessity and appropriate care, securing authorizations and coordinating with payors, patients, and interdisciplinary teams. This role emphasizes HIPAA...

Job Summary: Responsible for the oversight and management of skilled patients and temporary skilled patients in rehabilitation in contracted Skilled Nursing facilities; this includes checking benefits, managing up to discharge and issuing denial...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

UnitedHealth Group is seeking an OptumCare MBI NCM to serve as a clinical liaison, coordinating care across settings for high-need members. The role emphasizes evaluation, care planning, and documentation in EMR systems. The position allows...

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...