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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...

Description: Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient...

CVS Health is seeking a Case Manager RN for a fully remote telephonic role focused on assessment, planning, and coordination of case management activities for members of Federal Plans. You will enhance member wellness and advocate for patients...

Sedgwick is seeking a Telephonic Case Manager (RN) for a fully remote role in the United States. You will partner with injured workers, employers, and medical providers to develop case management strategies aimed at medical recovery and successful...

Optum NY seeks an RN Case Manager to coordinate referrals for high‑risk members, educate patients on illnesses and treatments, and support care plans across the continuum. The role emphasizes strong clinical expertise and collaboration with...

Sentara Health is seeking a Remote Integrated Case Manager who will conduct telephonic and in-person assessments, develop and oversee comprehensive care plans, and coordinate authorizations within the benefits structure. The role requires an RN...

UnitedHealth Group is seeking an OptumCare Medical Behavioral Integration Nurse Case Manager (MBI NCM) to serve as a clinical liaison between Care Delivery customers and the clinical network in Washington state. The role involves assessing plans,...

Your job is more than a job You overthink every care option and scenario because, as a Care Manager, you're the hub of your patient's case management and care plan. You assure quality through the continuum of care, collaborate with members...

Job Description Are 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...

Ansible Government Solutions, LLC is recruiting multiple Remote Registered Nurse Case Managers to support the VA Office of Veterans Community Care. The role involves managing SEOC data, ensuring compliance, and reviewing provider and veteran...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Seeking a full-time RN Case Manager - Remote, who will manage care for members with complex and chronic needs by assessing, developing, implementing, and evaluating care plans while working primarily through telephonic communication.Key...

Job Title Works collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify member needs and...

Humana Inc. is seeking a remote Telephonic Care Manager to deliver comprehensive case management across the care continuum. You will coordinate with care teams, coordinate with facilities and providers, and serve as the main contact for...

Elevance Health is seeking an experienced nurse to review complex cases for medical necessity, applying clinical guidelines and nursing judgment. The role involves collaboration with physicians, case managers, and Medical Directors to optimize...

Quartz Health Solutions is seeking a licensed RN for a Utilization Management RN Case Manager role in Wisconsin. You will review prior authorization requests, coordinate transitions back to in-network services, and collaborate with physicians,...

Position Title: Remote Telephonic RN Case Manager Mandatory Requirement: Must hold an Active Compact RN License and/or an Active California (CA) RN License to be considered. Pay Rate: $48.00 – $50.00 per hour...

Premera Blue Cross seeks a licensed RN/ARNP with case management experience to work remotely as a Case Manager. The role focuses on whole-person care, coordinating with clinicians to assess barriers and create member-centered care plans. Training...

RN CASE MANAGER – CARE MANAGEMENT DEPARTMENT - University of New Mexico Hospital – Albuquerque *Inpatient *Outpatient *Utilization Management *SRMC Care Management *Full Time *Part Time Receive 17% Weekday Nights, 26% Weekend Nights and 15%...

Guidehealth is seeking a remote-based Care Manager (RN) to guide patients and families through complex health journeys. You will blend clinical expertise with holistic care, addressing medical, behavioral, and social needs while coordinating...

UnitedHealth Group's Optum Care at Home is seeking a Telephonic RN Case Manager to serve as primary contact for members with complex medical, behavioral health, functional, and social needs, coordinating care across Medicaid LTSS, home health, and...

Ascension is seeking a Registered Nurse for the Case Management team. This role reviews admissions and service requests for medical necessity, coordinates discharge planning, and supports coding, documentation, precertification, reimbursement and...

Sentara Health in Richmond, VA is hiring an Integrated Case Manager, RN to coordinate patient care across the continuum. This remote-friendly, full-time role requires in-person assessments and travel to Winchester, Leesburg, Alexandria, and other...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

A reputable healthcare staffing firm in Oregon is seeking a care manager specializing in phone communication with patients across all ages. The role involves coordinating care services, educating patients on their health conditions, and conducting...