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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,...

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...

Springfield Clinic, Springfield, IL, is seeking an RN TeleNurse to triage patient calls, provide leadership within the department, and advocate for patients. The role emphasizes applying the nursing process, clear communication, and coordination...

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,...

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,...

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...

Clinical Appeals Nurse (RN) | Remote | Contract Walker Healthforce is seeking a Clinical Appeals Nurse (RN) with 2+ years of clinical nursing experience to provide clinical review and...

Immediate Hire for Hospice RN Case Manager Immediate hire for Hospice RN Case Manager to join our Hospice Team! We provide high-quality, compassionate care focus on encouraging independence in the comfort and security of our patient...

Nurse Care Manager - Telephonic (Local Remote) Tandigm Health, a transformational leader in population health management, is looking for a Nurse Care Manager - Telephonic in the greater Philadelphia area. We offer a competitive...

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,...

RN Hospice Case Manager We are hiring a full-time RN Hospice Case Manager to join the Athena Home Health & Hospice team in the Torrington area! This position is on-the-road covering Litchfield County and western Hartford County.

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...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

Become a part of our caring community As a Clinical Manager at CenterWell Home Health, reporting to the Branch Director, you support a team of dedicated clinicians who deliver compassionate, high quality care in the home setting. By guiding clinical...

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...

Full-Time Case Manager(LPN/LVN)Are You Ready to lead in Healthcare? We are currently seeking a Full-Time Case Manager(LPN/LVN) to join our outstanding healthcare team!Salary Range: $83,200.00 per yearWe are passionate about providing high-quality...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

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...

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

Job Description Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally for excellence in cancer treatment,...

Arkansas Blue Cross and Blue Shield seeks an Appeals Coordinator with a strong nursing background to review adverse benefit determinations within regulatory timeframes. You will apply medical guidelines and corporate policies, drawing on HCPCS/CPT...

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...

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...

RN CDI Specialist As one of the Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review, we're working to create a national model for improving health. Today, we're focused on bringing our region services that improve every...