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JOB DESCRIPTION Candidates must hold a current California license, 2-3 years case management exprience reside in the San Diego, California area , and be able to travel up to 10% ...

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 with the care, pharmacy benefits, data...

Providing clinical review support on an as-needed basis, the part-time PRN Clinical Review Nurse (RN) will review medical records for medical necessity, authorization compliance, and payer guideline alignment while supporting appeal submissions...

#SRN This position represents 5 openings. Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in...

Optum Waste and Error Claims Investigator 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...

The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This includes conducting patient evaluations, managing admissions and informational visits, and ensuring timely...

Job OpportunitySeeking 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 opportunity...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

LanceSoft is seeking a travel nurse RN Case Management for a travel nursing job in Santa Monica, California. Job Description & RequirementsSpecialty: Case...

Become a part of our caring community Humana Gold Plus Integrated is seeking a Field Care Manager Registered Nurse (RN) to assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members and...

We are looking for a L&D Nurse to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model. Physicians & Advanced Practice...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

U.S. Army Family Nurse Practitioners perform the highest level of quality care for Army Soldiers, retirees, and their families. If you are looking to combine your skills as a family nurse practitioner and your passion for...

Guidehealth is seeking a Utilization Management Registered Nurse (RN) for a fully remote, full-time position. The role involves applying medical necessity criteria to reviews, documenting findings, and interfacing with providers and members to...

Senior Specialist, Quality Improvement (Registered Nurse) Reason for opening: FTE support needed for "Q4 Push" to close Medicare/MMP gaps in care with member & community events Will this role be fully remote? Yes Are there...

Alliance Health in North Carolina is seeking a Telework-enabled Care Management Consultant who will provide secondary care coordination and medication reviews for members with physical health needs. The role requires licensure in NC (RN or OT/PT)...

Job Description: We're seeking a highly skilled critical care nurse with at least three years of ICU or Emergency Department experience to join our flight team. You'll provide advanced care to critically ill and injured patients during air and...

Description Location: UCHealth UCHlth Anschutz Inpt Pavilion, US:CO:Aurora Department: Mother Baby Unit AIP Work Schedule: Full Time, 72.00 hours per pay period (2 weeks) Shift: Nights Pay: $35.29 - $54.71 / hour. Pay is dependent on applicant's...

Clinical Professional Opportunity At Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and...

Nurse Navigator 2 The University of Miami/UHealth Department of Medicine has an exciting opportunity for a Full-Time Nurse Navigator 2 to work in the UHealth Campus. Core Job Summary: The Nurse Navigator 2 (H) liaises...

Air Evac Lifeteam seeks a licensed RN to write clinical insurance appeals and support medical necessity justifications for air transport evaluations. The role involves processing and submitting appeals, ensuring timely updates, and protecting...

Centene is hiring for a Care Manager (RN) to develop, assess, and facilitate complex care management activities for members with physical needs. This role targets nurses with bedside NICU experience and a passion for high-quality, cost-effective...

Nurse Case Manager IIDo you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.The Nurse Case...

Townsen Memorial is looking for a full time Registered Nurse, PAT to join our team remotely ! Must reside in Texas. SUMMARY The Registered Nurse, Pre‑Admission Testing (PAT) is responsible for...

Description The Journey Clinic RN provides comprehensive nursing care for patients in an ambulatory care environment based on individual physical, emotional, spiritual needs, and appropriate care strategies throughout the lifespan. This position...