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Blue Shield of California is seeking a Case Manager with a nursing background to perform UM and CM activities, collaborating with members and clinicians. The role focuses on planning, assessment and care coordination within established guidelines.

Department: 01223 AMG WI Department of Digital Medicine - Virtual Practice Support Status: Full time Benefits Eligible: Yes Hours Per Week: 40...

The Supportive Housing Case Manager (Ages 18–25) supports young adults in securing and keeping stable housing while building life skills and independence. Using a positive, youth-centered approach, you'll carry a small caseload (12–18...

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...

Job Title: Admissions Nurse Salary Range: $48 - $51 / Hourly Job Description Have you ever considered hospice as a clinical specialty—one that blends clinical expertise with deep human connection? Just like cardiology or...

Description: Our client is seeking an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role, you will perform concurrent reviews, prior authorizations, medical necessity...

Medical Review RN IV – Commercial Appeals & Grievance Nurse Location: Remote – Candidate Must Reside in California Duration: 6+ Months Contract-to-Hire Schedule: Monday-Friday | 9:00 AM – 5:00 PM Pay Range:...

Asct is seeking a Nurse Manager for the Mother Baby unit at LBJ hospital in Houston, Texas. This position encompasses operational management and quality delivery of nursing care, ensuring standards set by regulatory agencies are met.The ideal...

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...

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,...

Clinical Triage Specialist (CTS) (RN) - Access Center St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are...

Benefits: Health insurance Paid time off 401(k) Opportunity for advancement About the Role: Only Care Home Health is looking for a compassionate and dedicated LVN Case Manager to join our growing team in...

The nation's leading administrator of long term care insurance services is looking for YOU. This is your opportunity to join a company with a culture that promotes respect for people, integrity, learning and initiative.

Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13208 Salary Range:...

University of Southern California seeks a Licensed Vocational Nurse (LVN) to support the Continuum of Care team in discharge planning and post-discharge coordination. You will partner with nurses, social workers and case managers to ensure...

Professional Care Manager (RN) UPMC Hillman Cancer Center is internationally recognized for its leadership in the prevention, detection, diagnosis, and treatment of cancer and is the region's only comprehensive cancer center designated by...

Site: Mass General Brigham Medical Group Northern Massachusetts, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our...

San Dimas Community Hospital is a 101 bed facility located on a 13-acre campus in the heart of San Dimas. With a multidisciplinary team of experts and state of the art technology, we are committed to serving the community with personalized,...

Job Summary Provides assessment and nursing intervention in all areas of Infusion Therapy when requested by physicians and/or clinical trial protocols in the outpatient setting. Performs the nursing process through individualized assessment,...

Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs. We're more than just a team; we're a close-knit community. Our shared commitment to caring for each other and those we serve is...

OverviewPosition Type: Full timeJob Title: Care Review Clinician ILocation: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle),...

Job Title Full Job Description Responsibilities: Provide skilled professional nursing care to patient/family/caregivers Oversee and provide primary care, including all clinical care, palliative care, and...

Licensed Practical Nurse (LPN) (LVN) CareHarmony's Care Coordinators (LPN) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced...

" Licensed Psychiatric Nurse Practitioner Wage: Up to $196.58/hour Did you know that you can build a flexible...

Description Position at Healthmap Solutions Company Background Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise...