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Santa Barbara Cottage Hospital is seeking a Telephonic Nurse Case Manager to assess and coordinate care for injured workers. Responsibilities include planning and implementing medical case management, ensuring timely communication with all...

Molina Healthcare is hiring a remote RN Care Manager with a preference for candidates in Washington State. The role operates on Pacific Standard Time hours and focuses on telephonic case management for Medicare members, with no travel, direct...

Virginia Mason Franciscan Health seeks an LPN Case Coordinator to coordinate patient care under physician/ARNP guidance. You will guide intake, diagnosis, treatment, and discharge, ensuring referrals reach the right specialist and coordinating...

Case Manager Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases are maintained by Case Managers. The employee reports directly to the Supervisor, Case Management (LCSW). In addition, the role...

Revive Therapeutic Services seeks a Nurse Case Manager to oversee patient care plans and coordinate services for individuals facing health challenges. You will collaborate with patients, families, and providers to ensure effective care delivery.

A health care provider organization is seeking a Case Management Nurse to coordinate care for members. This role requires a Nursing Diploma and direct clinical experience, along with the current Michigan RN license. Responsibilities include...

AmTrust Financial Services, Inc. is seeking a Telephonic Medical Case Manager, RN, to provide comprehensive telephonic case management and drive a medically appropriate return to work for injured employees. This remote role supports PA and...

Actalent is seeking a Case Management Nurse in Milwaukee, WI to coordinate comprehensive patient care and advocate for access to services across the continuum of care. The role blends direct client contact with care coordination, education,...

Engage patients telephonically to assess needs and prioritize care.Collaborate with providers to coordinate care and transitions.Provide education and resources to patients and caregivers.What Will Make You Successful Here: Hold an active RN...

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...

Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after training: M-F...

Womble Bond Dickinson (US) LLP seeks a Nurse Consultant to join our team. The Nurse Consultant provides high-level medical analysis and insight in support of legal matters, reviewing, interpreting, and synthesizing complex records into clear,...

CVS Health's Aetna team is seeking a Case Management Coordinator to support dual eligible members across the country. This remote role requires travel within Kane and DuPage Counties and surrounding areas, focusing on coordinating benefits and...

Opus Medical is seeking a Nurse Liaison to coordinate care and communicate key medical information among the Injured Worker, Insured, and Carrier. This remote, field-based role involves regular local travel, ensuring successful rehabilitation and...

Iconma Portal is seeking a Registered Nurse-Review Analyst for a remote position with a Health Insurance client. You will conduct prospective, concurrent, and retrospective reviews across inpatient, outpatient, ambulatory, and ancillary services...

A healthcare services provider in Cleveland, Ohio, is seeking a Case Manager Nurse Advocate. This position offers remote work flexibility and requires an active nursing license and a Bachelor of Science in Nursing (BSN). The ideal candidate will...

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...

Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

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...

Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

Job Description Responsibilities: Job Summary: The Case Manager oversees the process of care delivered to patients, works collaboratively, and provides leadership to the healthcare...

Position Summary The Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective...

Centene is seeking an RN with strong appeal review experience to act as liaison for statewide appeals, fair hearings, and review organizations. This fully remote role supports members and providers while ensuring compliance with State and NCQA...