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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,...

Position Summary Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality,...

Namely is looking for Nurse Care Managers based in California to join their Care and Case Management team. The role involves guiding members through complex healthcare situations and developing cohesive care plans. The ideal candidate will...

Quality of Care Investigative Nurse - Arizona Remote Join the Arizona Division of Developmental Disabilities' Quality Management team and help protect the health, safety, and well-being of individuals receiving...

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...

Baptist Health is seeking a remote Clinical Documentation Specialist to evaluate physician documentation and ensure accurate illness severity portrayal for coding precision. The role requires an active Kentucky license and involves guiding...

Nurse Case Manager The Nurse Case Manager (NCM) is responsible for applying medical knowledge in reviewing workers' compensation claims to assess, evaluate, plan, implement and oversee the treatment appropriateness for occupational...

Job Title Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner...

Utilization Management (UM) Nurse Supervisor The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and...

Inland Empire Health Plan is seeking a Claims Review Nurse, LVN to perform timely medical reviews of facility and professional claims. You will identify improvements in the UM/Claims interface and support clinical determinations under supervision,...

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...

Alora Supports Missouri LLC is seeking a Regional Manager RN to provide clinical oversight and operational leadership across the Southern Missouri region. The role blends hands-on nursing responsibilities with strategic management, requiring a...

Job Details Field Nurse Case Manager (Remote) 2026-1480 Bethesda, Maryland, United States Medical Case Management Full Time Description Overview Are you looking to make a difference by...

Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles, California. Serving over 100,000 patients annually, the...

Join Cedars-SinaiCedars-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 among the very best in...

Job Responsibilities: The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and...

Job Title This is a remote, PRN position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

CVS Health is seeking an experienced Registered Nurse to support 24/7 Utilization Management, reviewing cases, assessing medical necessity, and coordinating care from a remote home office. Candidates must hold an active RN license and have at...

About the Job ASSIGNMENT SUMMARY: The Registered Nurse (RN) will be responsible for coordinating, implementing and supervising all nursing and personal care services at the Adult Day Health Care Center. The...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote capacity. The role reviews inpatient and outpatient services using evidence-based criteria, authorizes care with providers, and escalates cases as needed.

Optumcare Medical Behavioral Integration Nurse Case Manager For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care.

Hospice Admissions Nurse Peoples Health Services is the only family-owned, locally governed Hospice and Home Health provider in the Florida Panhandle. We believe that when we take care of the people who care for our patients, everyone...

Acentra Health is seeking a Clinical Manager (RN) to provide clinical and operational leadership for CA UIS Care Coordination and Case Management programs, ensuring quality outcomes and contract performance. This remote California role supports...

CVS Health is seeking a remote RN Case Manager to support members across multiple states. You will assess needs, apply clinical guidelines, and coordinate care with care teams to optimize outcomes. The role emphasizes holistic,...