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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,...

Under the direction of the Assistant Director, the Intensive Case Management Medicare Advantage Utilization Review Nurse performs utilization review of medical necessity and appropriateness, cost containment and efficiency, compliance 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...

CorVel is seeking a Utilization Review Case Manager for a remote position in California. The role involves gathering demographic and clinical data, certifying medical necessity, and assigning appropriate lengths of stay for in-patient and...

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...

UnitedHealth Group is seeking a registered nurse to provide guidance and education as part of a new program. The role emphasizes frontline clinical resource support, member education, and care coordination across the continuum of care. You...

Case Manager RNBurbank, CA$2537 /Weekly Gross**Estimated pay package. Does not include taxes, insurance, or other deductions that may occur8H Days26 Weeks40Short Term Acute Care Hospital368EPICRequirementsAt least 2+ years' experienceEither an...

Guidehealth is a remote-first healthcare company seeking an experienced RN Case Manager with an Illinois license to join the Value Based Care Services team. The role focuses on improving member management, satisfaction, and cost effectiveness...

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...

The Ohio State University is seeking a Clinical Financial Case Manager - RN to join our Revenue Cycle Clinical Support team in a remote capacity. The role focuses on securing pre-authorizations, preventing denials, and appealing denials with...

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...

CVS Health is seeking a Case Manager RN for a fully remote role. The position supports members with assessment, planning, and advocacy to meet health needs and benefits, with no travel and a standard Mon-Fri schedule, aligned to the resident time...

Offres d'emploi Crawford - Mondiales is seeking an RN Case Manager for the South Los Angeles County region. The role is remote with local field travel and offers a competitive salary, with quarterly bonus opportunities and resources such as free...

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...

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...

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...

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...

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 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...

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...

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...

Care Career is seeking a travel nurse RN Care Manager for a travel nursing job in Burbank, California. Job Description & RequirementsSpecialty: Care...

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...

Description Job Title Nurse Case Manager 2 Location FL - Remote Position Description The Care Manager-Registered Nurse is a key member of our...

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...