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Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care services including SNF, home health and DME.

Compensation: $85,000 – $92,000 Hourly Equivalent: ~$41–$44/hr Location: Remote Schedule: Must work AZ hours (typically 1st shift) CLIENT NOTES / EXPECTATIONS Candidates must meet required AND preferred...

Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...

CVS Health is seeking a dedicated RN Case Manager in Massachusetts to coordinate comprehensive care for members, develop care plans, and communicate with providers and families. The role focuses on monitoring progress, advocating for patients, and...

This position will be paying $26.50/hr for an LPN and $28.50/hr for an RN Job Description The Clinical Quality Assurance Coordinator is responsible for ensuring case reports are of the highest quality and integrity and in full...

About This Role As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of health services by assessing and interpreting member needs and identifying solutions to help members live healthier lives.

Baptist Health is seeking a Clinical Documentation Specialist for a remote role requiring residence in KY or IN. You will evaluate physician documentation to ensure accurate severity of illness and guide clinicians on best practices in clinical...

Jobgether is seeking a Case Manager – Utilization Review Specialist for a remote United States position. You will use your nursing expertise to evaluate medical records, assess medical necessity, and manage appeals to support patient care and...

Insight Global is seeking a Remote Nurse Care Manager to support a virtual care and healthcare navigation company in the United States. The role involves collaborating with a multidisciplinary team, coordinating care for high-risk members, and...

Job Description SummaryCome join our MUSC Marion team!EntityMedical University Hospital Authority (MUHA)Worker TypeEmployeeWorker Sub-TypePRNCost CenterCC001637 MAR - MedSurg 2nd Floor (MMC)Pay Rate TypeHourlyPay GradeHealth-19Scheduled Weekly...

Summary Home Telehealth Care Coordinator (HTCC) Registered Nurse (RN) demonstrates leadership - experience - and creative approaches to management of complex patient care. The HTCC is responsible for coordination of health care for a...

SHIFT: Any (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

Intermountain Health is seeking a Registered Nurse for a fully remote Home Health and Hospice role (St George) with flexible, part-time scheduling. You will assess, plan, and deliver evidence-based care in patients' homes, using technology and...

Inova Health seeks an Outpatient Registered Nurse (RN) for the Anytime Program to provide Virtual On Demand care/triage when practices are closed, typically 5pm–5am with weekend and holiday coverage. Remote work is possible if based in the DMV...

Registered Nurse (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

Asante is seeking a Utilization Review Nurse to monitor utilization from preadmission to discharge, ensuring cost-effective, quality patient care and regulatory compliance in a remote, full-time role. The position includes a set weekend schedule...

Humana seeks a Utilization Management Registered Nurse to interpret and support medical services coordination, documentation, and benefit determinations. You will work remotely, reporting to the Manager of Utilization Management as part of the One...

Medical Director Services PC is seeking compassionate RNs or LPNs for a Hybrid RN/LPN – Patient Monitoring & Care – Remote role. You will monitor patients' vitals via our RPM platform, review biometric data, and identify abnormal trends while...

Vail Health is hiring a Triage RN to perform care coordination and triage, assessing patient health concerns and directing dispositions to emergency care, urgent care, or clinics. You will triage calls and portal messages, document assessments in...

Curana Health seeks an experienced Utilization Management Nurse to review and monitor members' use of healthcare services, ensuring high-quality, cost-effective care. The role emphasizes concurrent review, discharge planning, and high-dollar...

OhioHealth Corporation's Riverside Methodist Hospital seeks a Clinical Documentation Specialist for a full-time day shift. You will review inpatient records to accurately reflect severity of illness and risk of mortality, and collaborate with...

Back RN/Managed Care Coordinator - Remote Healthcare Columbia , South Carolina Contract Hybrid Oct 30, 2026 RN/Managed Care CoordinatorJob at a GlanceTitle: Managed Care...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

At Avanta Care, we prioritize the well-being of our employees. Our culture is built on the foundation of compassion, respect, and teamwork. We believe that when our employees feel valued and supported, they are better equipped to provide the...