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Case Management Utilization RNSalary: $68.95 - $84.38 / hourLocation: Los Angeles, California, Los Angeles Medical CenterEmployee Status: RegularSchedule: Part-time, 32 hours per week, Day shiftJob Summary:Works collaboratively with an MD to...

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...

HCSC is seeking a remote QOC Nurse under the supervision of the QOC Manager to conduct review and investigation of quality of care issues. The role supports quality improvement activities in compliance with CMS, NCQA and other regulatory...

Sentara Health is hiring a Remote Utilization Review Registered Nurse to perform prior authorization and utilization review for inpatient and outpatient services. Candidates must reside in Virginia and hold an active Virginia RN license. As...

BlueCross and BlueShield of South Carolina seeks an RN Medical Reviewer II to join the Palmetto GBA Medical Review team. You will perform medical reviews using clinical information, apply guidelines, and help ensure accurate coverage and payment...

A leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services. Responsibilities include processing authorization requests, ensuring compliance with Medicare...

TriWest Healthcare Alliance is seeking a Utilization Management Clinical Review nurse to assess medical necessity and manage prior authorizations for Behavioral Health and Medical/Surgical requests. You will apply InterQual criteria, document in...

Sedgwick is seeking an RN Telephonic Case Manager to support injured workers remotely. You will partner with workers, employers, and medical providers to develop care plans that promote medical recovery and a successful return to work. The...

Buena Vista Home Health, Palliative Care & Hospice (BV) is seeking an experienced OASIS Review Nurse (RN) for a remote, part-time QA role. The RN will ensure OASIS assessments are accurate, complete, and compliant with CMS regulations and state...

8 Hours POSITION SUMMARY The Clinical Staff Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of patient care.

Salary Range: $350,775.00 to $441,423.00 Potential Premium Earnings: $63,264.00 Salary range includes incentives that are contingent upon skills, competencies, longevity, experience and...

Intermountain Health is seeking an RN Utilization Review Care Management I for remote work. The role focuses on screenings, assessments, and evaluations to ensure cost-effective, high-quality care while coordinating with patients, families,...

UnitedHealthcare is seeking an HSS Clinical Coordinator RN to serve as the primary care manager for a panel of members with complex health needs, including behavioral health, with a focus on coordinating medical, behavioral, and social...

Wellstar is seeking a Remote RN to join an interdisciplinary team delivering high-quality patient care via phone or secure messaging. This role is fully remote and led by a nurse supervisor. An active RN license and BLS are required, with Georgia...

UnitedHealth Group is seeking an RN On-Call for hospice care to provide after-hours clinical support, triage patient needs and coordinate care for continuity and quality outcomes. The role includes remote and field-based nursing support with...

Conduct telephonic nursing assessments and triage using protocols.Provide health education and referrals to diverse patient populations.Work Schedule:Full-time evenings with weekend shifts every two weeks.Virtual training for 2-4 weeks, 100%...

The University of Texas MD Anderson Cancer Center is seeking a Denials Management Coordinator to support revenue cycle operations by coordinating review, analysis, and resolution of insurance denials and to help secure accurate reimbursement. This...

Job Description: RNs at Intermountain Healthcare are committed to providing patient centered care while demonstrating our values and mission. If you are interested in contributing to our mission of helping people live the healthiest lives...

Cambia Health is seeking an Utilization Management Nurse to work remotely within Oregon, Washington, Idaho or Utah. The role focuses on prospective, concurrent and retrospective reviews to ensure medical necessity and cost-effective care, applying...

JOB DESCRIPTIONWe are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance Abuse...

Cardinal Health, Inc. in the United States is seeking a Nurse for Individualized Care to educate patients, schedule calls, and coordinate services for patients on client products. You will handle inbound and outbound calls, educate on...

Seeking a full-time LVN who is passionate about mental health. This position is specifically for 6.30am- 7pm.Who We Are:Since 2000, Clearview Treatment Programs has offered individualized evidence-based treatment for adults suffering from mental...

Back RN/Managed Care Coordinator (Remote) Healthcare Columbia , South Carolina Contract Hybrid Nov 10, 2026 RN/Managed Care CoordinatorJob at a GlanceTitle: Managed Care...

Job Description Job Description Bilingual Remote LPN/LVN - Clinical Interviewer 100% Remote | $25-$26/hour | Monday-Friday 11:30 - 8 PM EST (Can reside anywhere in the U.S. to be considered)...

Manage patients assigned to your Care Team, ensuring visit frequencies align with acuity levels. Communicate via phone and video conferencing, assess and enroll patients, and develop care plans. Manage medications,...