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Nurse - Clinical Review Performs utilization review of cases to determine if the request meets medical necessity criteria in accordance with medical policies agreed upon with the client and any applicable governing body. Facilitates...

FlexCare Nursing is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start...

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...

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...

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...

Health Services Nurse - Occupational Health (Full Time) Job no: HN26-NURSE-GEN Work type: Full Time Location: Los Angeles Categories: USH - Operations, Park & Resorts Operations...

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...

At St. Luke's, our dedicated team of Remote Patient Management RNs are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which...

Job Description Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News & World Report's "Best Hospitals 2024-25" rankings, as well as placed...

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...

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...

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:...

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...

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...

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...

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,...

Care Career is seeking a travel nurse RN Hospice for a travel nursing job in Glendale, California. Job Description & RequirementsSpecialty: HospiceDiscipline:...

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...

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...

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...

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 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,...