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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...

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...

Mercor connects elite creative and technical talent with leading AI research labs. A remote Utilisation Management leader role is available, requiring RN licensure and physician-advisor experience. Contract position with high-level...

Virtual Care Registered Nurse We are seeking a licensed Registered Nurse to deliver virtual care to patients on behalf of one of our partner organizations. This role involves delivering remote patient care, symptom triage, health...

Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13298 Salary Range:...

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.

8 weeks. DAYS - 5x8 SCHEDULE: M-F - 8am to 4:30pm Care Coordinator inpatient. Must Be/Have: Experienced CM • a RN • Discharge planning assessment exp • Excellent UR • Psych social assessment skills • Acute hospital...

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...

Job Title Employment Type: Full time Shift: Rotating Shift Description: This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint...

Registered Nurse-Patient Centered Home Care South Carolina, South Carolina The Transition Care Nurse (RN) promotes safe transitions across the care continuum by completing telephonic outreach to patients discharged from the...

Serving as a clinical subject matter expert, the full-time State Licensed Clinical Nurse Specialist will perform complex clinical reviews, manage appeals and claims-related cases, and collaborate across various operational areas in a remote...

Job Opportunity Our client is a private health management company devoted to providing an exceptional clinical team in the comfort, and privacy of a patient's own home. We are seeking dynamic, experienced, and compassionate Registered...

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12...

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Summary This is an OPEN CONTINUOUS ANNOUNCEMENT & will remain open until 10/29/2026 or until filled. Qualified applicants will be referred to hiring managers at regular intervals. Your application will remain active for 3 months.

Make a Difference Where It Matters Most Join a team that's been providing compassionate, patient-centered care to rural North Carolina communities for 50 years. At CommWell Health, you won't just care for patients, you'll...

Centene is seeking an RN with strong appeal review experience to act as liaison for statewide appeals, fair hearings, and review organizations. This fully remote role supports members and providers while ensuring compliance with State and NCQA...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

About the Job Job Description: All Care Home Health is currently seeking a Licensed Vocational Nurse (LVN) Care Coordinator to join our team supporting the Kaiser region. We...

Job Title This is a remote 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 guide...

Registered Nurse, Care Coordination / Incident Triage: Los Angeles, CA Job Type : Assignment City : State : CA Job Description: Registered...

Trustaff is seeking a travel nurse RN Clinic for a travel nursing job in Los Angeles, California. Job Description & Requirements Specialty: Clinic Discipline: RN Start Date: 11/02/2026...

Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform-bringing health plan administration, holistic...

Job Summary and Responsibilities As our RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these services. The RN Care Coordinator performs this...

PIH Health in Los Angeles is seeking an RN Peer Review Analyst responsible for retrospective medical record reviews, data compilation to validate quality and accuracy of documentation, and auditing charts for admission/continued stay. You will...