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A healthcare technology company is seeking a Remote Registered Nurse - Telehealth RN Case Manager responsible for coordinating and managing patient care using telehealth platforms. Candidates must have an unrestricted RN license in Michigan, at...

HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate discharge planning within Medicare, AHCCCS, Self-pay, and other payer guidelines. The...

Athens Administrators is seeking a Telephonic Nurse Case Manager to support our Managed Care Department. This full-time role is remote and can be located from multiple states; it operates 9am–5pm Pacific Time, Monday–Friday.

Guidehealth in the United States seeks an experienced RN Case Manager to work remotely with Illinois licensure. You will oversee member management, promote wellness, and support cost-effective care within a value-based care framework.

Optum Home & Community Care, part of the UnitedHealth Group 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...

Employment Type: Full time Shift: Night Shift Description: Position Summary: Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to...

Kaiser Permanente in Los Angeles seeks a Nursing Attendant to support patient care under supervision of a Registered Nurse or physician. You will assist with daily activities, ensure patient safety, and communicate patient needs to the care...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

COPE Health Solutions is seeking a qualified Utilization Management Nurse (RN) to assess member needs, determine medical necessity and coordinate care across providers and care teams. This full-time, remote position reports to Medical Management...

A healthcare solutions company is seeking a remote Case Management Nurse to lead a multidisciplinary team providing holistic care. The role requires a compact RN license and offers a pay range of $37.00/hr - $39.00/hr. Candidates should have 3...

Wellmark is seeking a Case Management Nurse I to actively engage members through various channels, build individualized care plans, and coordinate services with providers and families. You will support chronic and complex health needs while...

CorVel Corporation is seeking a Utilization Review Case Manager for a fully remote role in the United States. The position requires current nursing licensure and 4+ years of clinical experience with preferred exposure to utilization review.

aptihealth is seeking a Registered Nurse Case Manager to support both patients and providers across the care continuum. In this key role, you will assess patient needs and coordinate care while ensuring compliance with regulatory requirements.

Oscar Health is hiring a Case Manager to join our Complex Case Management team. You will collaborate with Oscar teams to deliver high-quality care and improve member health outcomes, educating members, evaluating SDOH, and connecting individuals...

Guidehealth is seeking a Remote RN Case Manager licensed in Illinois to support member management, enhance satisfaction, and navigate the health care system as part of Value Based Care Services. The role focuses on data collection, clinical...

SCAN Group is seeking a remote RN to enhance frail seniors' ability to age in place by delivering person-centered care via telephonic care coordination. You will develop and implement plans of care, educate members, and coach them to manage...

Optum is seeking an After Hours Care Manager - LPN in California to support discharge planning, transfers, and ED diversion. This role involves telephonic coordination, collaboration with hospitalists and care teams, and ensuring timely, compliant...

Berkley Medical Management Solutions (BMMS) is hiring a Telephonic Nurse Case Manager to coordinate medical case management and facilitate timely return-to-work for injured workers in the United States. The role involves close communication with...

Virtua Health is seeking a remote RN to support the application of medical necessity tools, ensuring compliance and achieving positive patient outcomes. You will collaborate with Physician Advisors, manage denials, and document review activities...

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through...

Job Description: The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing...

Santa Barbara Cottage Hospital is seeking an experienced RN/LPN to perform remote clinical reviews for appeal cases. You will review medical records, apply InterQual criteria, and prepare clinical determinations for physician review. The...

CVS Health is seeking a Case Management Coordinator to collaborate with care teams and facilitate healthcare outcomes for members enrolled in Medicare and Medicaid. The role requires 50-75% travel within Illinois, strong analytical and...

Job Description You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive...

A growing telehealth women's health program is seeking a Board-Certified Womens Health Nurse Practitioner (WHNP) to provide comprehensive virtual care focused on perimenopause, menopause, and midlife health. This fully remote role offers...