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Overview The Registered Nurse Case Manager - Transitions of Care is a clinically experienced registered nurse responsible for leading care coordination for patients with complex and chronic medical conditions during...

Level I Utilization Management Nurse Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive...

Mass General Brigham Health Plan Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we...

Integra Partners is seeking an LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. You will collaborate with our Medical Director to review benefit and...

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure...

Details Client Name Cedars-Sinai Medical Center Job Type Travel Offering Nursing Profession RN Specialty...

Details Client Name Kindred Hospital - Paramount Job Type Travel Offering Nursing Profession RN Specialty...

Registered Nurse – Case Manager Day shift, Monday to Friday, from 08:30 to 17:00. Every other weekend is required, with every weekend preferred. Holidays are also required. Assignment Details Contract length is 13 weeks.

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...

Acting as the liaison for statewide appeals, the full-time RN Licensed Clinical Appeals Coordinator will ensure compliance with State and NCQA requirements while reviewing clinical information and preparing response letters for member and provider...

AvonRisk Utilization Review Nurse AvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32...

RN Case Manager Coordinates management of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care...

Job Title Job Description For this role, they are looking for an active Registered Nurse licensed in California, with current BLS certification and at least 3 years of acute care case manager experience. Epic 3 years...

Medical Management And Health Education Program Coordinator Fully Remote JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs.

KalCare Health Care is seeking an experienced LPN to join our clinical team as LPN Care Coordinator & Clinical Education Coordinator. This role focuses on care coordination, caregiver education, clinical supervision, teaching, mentoring, and...

Case ManagerAre you ready to bring your clinical competencies to a world-class Medical Group known for the very highest clinical standards? Do you have a passion for the highest quality and patient satisfaction? Then please respond to this dynamic...

The Department of Family Medicine of the Keck School of Medicine of USC provides care for every member of the family, across generations and over lifetimes. We aim to enhance the quality of life for underserved and vulnerable patients while...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health,...

Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people...

LTSS Service Coordinator – RN Clinician (Case Manager) Hiring in the following counties: Richland, Franklin, Muskegum, Guernsey, Noble, Washington, Morgan. Location: This field-based role enables associates to primarily operate...

RN - Case Manager About the Position Specialty: RN Case Manager Experience: 1+ year of recent case management or discharge planning experience preferred License: Active State or Compact RN License Certifications: BLS – AHA Must-Have:...

Details Client Name PIH Health Hospital - Downey (FKA Downey Regional Medical Center and Downey Medical Group) Job Type Travel Offering Nursing...

Admissions Nurse Do you enjoy being at the beginning of the journey? The Admissions Nurse is responsible for establishing and maintaining positive relationships with customers and referral sources within the community. The Admissions RN...

JOB SUMMARY This is a full-time REMOTE position requiring weekend availability (Saturday and Sunday) in addition to three weekdays. Company Highmark Inc. Job Description This is a full-time REMOTE position...

GLC On-The-Go is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Torrance, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN...