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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...

Optum Home & Community Care , part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical,...

Work From Home Nurse Practitioner (Remote Acute Visits, $210/hr)Join to apply for the Work From Home Nurse Practitioner (Remote Acute Visits, $210/hr) role at NPHireThis range is provided by NPHire. Your actual pay will be based on your skills and...

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...

Job OverviewPay Range: $46.76hr - $51.76hrRequirement/Must Have5+ years Clinical nursing experience.2+ years Care Management.Bachelor's Degree in Nursing.In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required...

Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00...

Serving as a clinical subject matter expert, the full-time State Licensed Clinical Nurse Specialist will perform complex clinical reviews, manage appeals and claims-related cases, and collaborate across various operational areas in a remote...

Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks an accomplished Infusion Referral Intake Coordinator...

Host Healthcare is seeking a local contract nurse RN Case Management for a local contract nursing job in Paramount, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 11/02/2026 Duration: 13 weeks 40...

JOB DESCRIPTION Supportive Housing Case Manager (CNA/LVN) Program Type: Mental Health - Supportive Housing Services Schedule: Monday - Friday | 4:00 PM - 12:00 AM | Full-Time (40 hours/week) POSITION...

Job Description: This position assists a nurse manager in managing daily nursing activities within a nursing department. The role involves providing leadership and performing management functions delegated by the nurse manager, such as resource...

Collaborate with physicians, psychologists, and therapists in a virtual pediatric clinic.Ensure seamless care delivery for children with chronic conditions.Responsibilities:Coordinate appointments, referrals, and care transitions.Provide patient...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity.You will perform concurrent reviews and engage with physicians to resolve...

$5,000 Sign-on Bonus for External Candidates Telephonic After-Hours Call - Per Diem Active Nurse Practitioner license in Connecticut or Rhode Island Required Optum Home & Community Care, part of the Optum family of businesses, is creating...

Come care with us at West Coast University! As a Nursing Academic Specialist for a certified Great Place to Work, you will guide nursing students to do more than change their own lives – you will help change the lives of...

AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Management for a travel nursing job in Glendale, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 12/07/2026 Duration: 13 weeks 40 hours...

Job Description Remote Prior Authorization LVN/LPN Location: Remote (United States) Type: W2 Contract (Temporary) | Hours: 40/week Pay Rate:...

Job Description Responsible for the retrospective review of medical records and compiling data to validate quality of care, appropriateness of care , and accuracy of documentation. RN Peer Review Analyst will audit charts for...

Telephonic Nurse Case Manager II Telephonic Nurse Case Manager II Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and...

Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are...

Weekend Nurse (LPN/LVN) At TeleMate Health, we are dedicated to transforming healthcare delivery through innovative solutions. Our mission is to provide a level of monitoring and clinical intervention that is unique to healthcare and...

Case Manager LVN Days Join our team in Los Angeles, CA, as a Case Manager LVN, focusing on patient care coordination and discharge planning. Position Details: Contract: 13 weeks, 40 hours/week, 9am-5:30pm, includes...

Sinai Hospital's Utilization Review operates as a distinct specialty service line of physician advisors, nurses, and support staff who ensure hospital stays are clinically appropriate and fully covered by the patient's insurance. The team focuses...

Jackson Nurse Professionals is seeking a travel nurse RN Interventional Radiology for a travel nursing job in Mesa, Arizona. Interventional Radiology Discipline: RN Start Date: 11/09/2026 Duration: 13 weeks 40 hours per week Shift: 10 hours, days...

To ensure timely and accurate care decisions, the full-time Utilization Review Nurse LVN/LPN will perform clinical reviews for medical necessity and benefit coverage, applying clinical guidelines and maintaining compliance in a remote work...