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Job Title Utilization Management Team Leader Job Description The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical...

Utilization Management Admissions Liaison RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide health...

ChartSpan is the largest chronic care management (CCM) service provider in the US. CCM and Remote Patient Monitoring (RPM) programs focus on patients who have multiple (two or more) chronic conditions that are expected to last at least 12 months...

Research Nurse (Per Diem) - Greater Portland, OR areaIllingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device industries. These include mobile research...

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,...

Pay: $30 - $35 / hour Weekly Pay | Flexible Scheduling Provide Care One Patient at a Time Join Maxim Healthcare and deliver personalized 1:1 nursing care in patients' homes. Enjoy consistent assignments, a manageable pace, and...

Clinical Guide Part A The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient, behavioral health, and/or post-acute authorization review in alignment with CMS and Medicare Advantage...

Licensed Vocational Nurse - Home Health Excell Home Care is actively recruiting for LVN Case Manager. Our innovative company is focused on the best possible outcomes for our patients, outstanding and highly personalized patient care, and...

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...

Salary: $82,555.20 - $123,822.40 Annually Location : Chaska Government Center, MN Job Type: Full-Time Remote Employment: Flexible/Hybrid Job Number:...

ExamWorks is seeking a self-driven RN or LPN to join our team as a Clinical Quality Assurance Coordinator. This 100% remote role supports peer review reports, ensuring high quality, evidence-based rationales, and compliance with client...

Salary : $105,247.44 - $157,542.24 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: PH5230F-EA Department: PUBLIC HEALTH...

Utilization Management Nurse We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for...

We anticipate the application window for this opening will close on - 28 Sep 2026 Careers that change lives start here. Medtronic is a global leader in healthcare technology with a Mission to alleviate pain, restore health, and...

Optum is seeking an After Hours Care Manager - LPN in California to support discharge planning, transfers, and ED diversion. This role involves telephonic coordination, collaboration with hospitalists and care teams, and ensuring timely, compliant...

Aya Healthcare has an immediate opening for the following position: Utilization Review Registered Nurse in Torrance, CA. We'll work with you to build the healthcare career of your dreams. Whether you want a job close to home or across the country,...

Clinical Appeals Specialist The Clinical Appeals Specialist completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Specialist utilizes...

Clinical Reviewer, Inpatient RN Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy...

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,...

Job Profile Summary Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's...

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 &...

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology...

Summit provides independent insurance agents and their clients with market-leading workers' comp insurance and elite customer service. We're growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South,...

See Your Work in a New Light At LUX Infusion, we're reimagining infusion care to be more human, supportive, and connected. Inspired by lux—meaning light - we guide patients, providers, and partners through complex therapies with...

IV Infusion Specialist Assessment Nurse The IV Infusion Specialist Assessment Nurse is responsible for identifying current and future patient care needs; being able to recognize normal versus abnormal body physiology. The role requires...