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City/State Lynchburg, VA Work Shift First (Days) Overview: Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for Charlottesville & Roanoke Virginia...

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately...

Remote RN Utilization Management Nurse (MLTC) Remote | NY RN License Required $62/hour We are seeking an experienced Registered Nurse (RN) with MLTC experience for a...

Are you a bedside nurse seeking a change from the hospital setting? If you answered "yes", Alliant Health Solutions, a "2025 Best Place to Work and Healthiest Employer", may be the place for you! Alliant is recruiting...

Immediate Hiring for "Remote Clinical Review Nurses" Job Description: Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital...

WHO WE ARE: GlobalHealth is a fast-growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and retaining a highly talented workforce. Our passion is Genuine...

Description Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued – they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of...

Shift: Night Working Hours: 6:30p-7a Summary: The Admission/Discharge Registered Nurse (RN) is a member of the Nursing Care Team and is responsible for collaboration, communication & facilitation of optimal provision of...

Description Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses clinical knowledge to provide...

Job Type Full-time Description Join our team and earn a $4,000 sign-on bonus! | No Nights | No Weekends | Paid Holidays | | Competitive Pay | Bonus Potential | Generous Benefits/Retirement...

Job Title: Utilization Management Nurse - Behavioral Health Focus (Remote) Time Zone Preference: Pacific or Mountain Time Zone is preferred Work Schedule: Tuesday through...

About Umpqua Health At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our...

Immediate need for a talented Registered Nurse Utilization Review - Onsite-Santa Clara, CA.This is a 03+ months contract opportunity with long-term potential and is located in U.S(Remote). Please...

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Care Management - Nurse,...

RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City :...

JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory...

City/State Lynchburg, VA Work Shift First (Days) Overview: Overview We are seeking a compassionate and experienced Registered Nurse - Integrated Care Manager...

Job Description: Position Summary: The Community Clinical Liaison performs a key role in the generation of referrals to HSL Home and Community Based Services with primary focus on Home Health and Hospice referral...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job...

Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our...

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...

Overview Connect Care. Guide Families. Make Every Day Count. We are seeking an experienced and compassionate Hospice Clinical Liaison to join our team. In this role, you will ensure that intake and referral processes...

These roles involve patient care, including assessment, diagnosis, treatment, and follow-up. May work across various healthcare settings, such as hospitals, clinics, long-term care facilities, and community health organizations. Responsibilities...

Job Description Summary The Utilization Review Registered Nurse is responsible for reviewing medical services to ensure they meet evidence-based guidelines and member benefit plans. This includes...

Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses clinical knowledge to provide judgment to...