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The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential Duties and...

Description As an RN Care Manager, you will function as a clinician, advocate, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN Care Manager...

Care Manager Sharecare is the leading digital health company that helps people no matter where they are in their health journey unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is...

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic...

Registered Nurse Case Review Specialist Position is Remote/Nationwide Job Summary STGi is currently seeking a Registered Nurse Case Review Specialist. The position is remote and open to candidates nationwide. Provides direct...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

A leading health care organization in Virginia is seeking a qualified Registered Nurse to handle HCBS authorizations and collaborate with providers. This role requires active RN licensure and at least three years of experience in an acute setting.

Sharecare is the leading digital health company that helps people no matter where they are in their health journey unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help...

A national health insurance company is seeking a Prior Authorization RN to review clinical appropriateness of prior authorization requests. This role is pivotal in ensuring compliance with Medicare and Medicaid criteria, while improving the...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

A healthcare consulting firm is seeking a Clinical Lead Consultant to join their team in Toledo, Ohio. This full-time, remote role involves consulting services for nursing facilities and includes responsibilities like MDS completion, auditing, and...

A leading healthcare organization in Stratford, Connecticut, is seeking a Nurse Home Visitor to provide home visiting services to families with newborns. The role involves health assessments, supporting parents with community resources, and...

Current Employees: If you are currently employed at any of the Universities of Wisconsin, log in to Workday to apply through the internal application process. Job Category: Academic Staff...

Description Join PeaceHealth in advancing compassionate, mission-driven care from wherever you are. PeaceHealth is looking for a skilled and motivated Registered Nurse Utilization...

JOB PURPOSE: Responsible for the oversight of clinical care management of community based long-term care population for PruittHealth Premier Dual Eligible Special Needs Plan (DSNP). Works to advise and coordinate clinical...

A healthcare organization is seeking a Registered Nurse Care Manager to provide member-centric case management services. This role includes conducting assessments and care coordination while ensuring that health needs are met through effective...

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to...

A leading health solutions company is seeking a Care Manager-Registered Nurse in Connecticut. This role requires developing and coordinating care plans for members with multiple chronic conditions while ensuring effective telephonic engagement.

Job Description Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant, pediatric,...

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best,...

Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

A leading healthcare provider is urgently seeking experienced Clinical Documentation Specialists for remote positions. Ideal candidates must be RN graduates from an approved nursing program and possess prior CDI experience, preferably in acute...

Clinical Research RN Days Shift Monday to Friday Urology Research Royal Oak, MI Scope of Work Join our team to support leading-edge research with a team of renown physicians. Urology Research has...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...