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Case Manager The Case Manager manages an individual caseload using the case management process in order to meet the needs of the MedWatch, LLC customers and consumers. This includes, but is not limited to, authorization of services,...

TriHealth is seeking a Utilization Nurse to evaluate medical necessity and ensure care is delivered at the appropriate level in collaboration with physicians, care management, and payers. The role requires RN licensure, 3–4 years of...

Centene Corp. in California seeks a remote nurse reviewer to handle medical necessity grievances, appeals and denials. The role requires CA RN/LPN/LVN licensure and 2+ years of clinical nursing experience, with NCQA and InterQual knowledge...

AmTrust Financial Services seeks a Telephonic Medical Case Manager (RN) to deliver comprehensive telephonic case management and drive appropriate return-to-work outcomes. You will collaborate with injured employees, providers, and adjusters to...

Molina Healthcare is seeking a remote RN Care Manager to support Washington State Medicare members via telephonic case management and care coordination. While remote, PST hours apply and candidates in WA state are preferred. No travel, no...

Registered Nurse (RN) | Case Manager Location: Paramount, CA Agency: Stability Healthcare Pay: $2,460 per week Shift Information: Days...

Telephonic Nurse Case Manager Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America, we're at the forefront of innovation and excellence, blending cutting-edge technology with...

Sedgwick Claims Management Services Ltd in New Jersey invites applications for a Field Case Manager covering the South Jersey region. You will collaborate with injured workers, employers and medical providers to plan medical recovery and a safe...

Full-time Company Description WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

Elevance Health is seeking a Nurse Case Manager II to oversee care management for members with complex and chronic care needs, assessing and coordinating care plans telephonically or on-site, including discharge planning. The role requires...

Description Job Title Nurse Case Manager 2 Location Remote - OK Position Description The Case Manager utilizes a collaborative process of...

To ensure high-quality patient care and appropriate admit status, the full-time Maryland Licensed Utilization Review Nurse will conduct admission concurrent and retrospective case reviews, collaborate with medical staff, and manage documentation...

Alignment Health is seeking a compassionate Registered Nurse for a fully remote Telephonic RN Case Manager role serving SNP members from home. You will conduct telephonic care management, assess needs, and develop care plans while coordinating...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Medical Solutions is seeking a local contract nurse RN Case Management for a local contract nursing job in Burbank, California. Job Description & Requirements Specialty: Case Management Discipline: RN Duration: 26 weeks 40 hours per week Shift: 8...

Sagility seeks an experienced Registered Nurse to join as a Senior Care Specialist in a work‑from‑home capacity. This seasonal role (ending June 2027) focuses on telephonic care, health coaching, and care coordination for members with chronic...

Field Case Manager Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an...

Senior Care Specialist (Registered Nurse) – Work From Home About Sagility Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw...

Required Skills & Experience • Active RN license (Compact license required)\n• 2–4 years of clinical experience (neurology and/or endocrinology experience preferred)\n• Strong interest in chronic disease management across neuro and...

UnitedHealth Group is seeking an experienced Behavioral Integration Nurse Case Manager to act as the clinical liaison between OptumCare/Care Delivery and the clinical network. The role focuses on assessing, coordinating, and evaluating care plans...

Description Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the patient's placement to be at the most appropriate...

Join us as we transform immunology and deliver medicines that help autoimmune patients get their lives back. argenx is preparing for multi-dimensional expansion to reach more patients through a rich pipeline of differentiated assets, led by...

A health care organization in Monterey Park is seeking a Case Manager (LVN or RN) to manage patient care effectively. This role involves working collaboratively with medical teams to establish discharge plans and ensure compliance with health...

Medicare and Medicaid managed care plans helping members stay independent.Supports Elderplan's SNP line of business.Responsibilities:Advocate for patients during care transitions.Collaborate with discharge planners and case managers via...

Amphibious Medics seeks an experienced RN to lead our Nurse Case Management function. This hands-on clinical and operational leadership role oversees three Case Officers, ensuring standards, quality, and timely return-to-work across multiple...