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Air Evac Lifeteam seeks a licensed RN to write clinical insurance appeals and support medical necessity justifications for air transport evaluations. The role involves processing and submitting appeals, ensuring timely updates, and protecting...

Centene is seeking a Care Manager (RN) to develop, assess, and facilitate complex care management for members with primarily physical health needs. This role is ideal for nurses who are passionate about providing high-quality, cost-effective...

Job Summary and Responsibilities As our Nurse Shift Manager, you will help lead and coordinate our exceptional nursing team so they can deliver timely, compassionate, and life-saving care to patients in critical...

Guidehealth is seeking a Utilization Management Registered Nurse (RN) for a fully remote, full-time position. The role involves applying medical necessity criteria to reviews, documenting findings, and interfacing with providers and members to...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

Nurse Manager The VA Greater Los Angeles Healthcare System (VAGLAHS), Surgery Service, is recruiting for a Nurse Manager to lead the Referral Coordination Program. The incumbent provides first-line supervisory oversight of clinical...

JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member...

Summary The VA Greater Los Angeles Healthcare System (VAGLAHS), Surgery Service, is recruiting for a Nurse Manager to lead the Referral Coordination Program. The incumbent provides first-line supervisory oversight of clinical referral...

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Temporary Senior Complex Case Manager (RN) Position Type: Temporary /...

Sedgwick Government Solutions is seeking a Telephonic Triage Nurse Case Manager (Remote) to support federal workers from a home office. You will conduct timely assessments, coordinate care, and manage cases to drive optimal recovery...

Alliance Health is seeking an UM Clinical Specialist RN for Physical Health who works remote with NC-based residency and occasional travel for in-person meetings. The role focuses on medical necessity reviews for inpatient and outpatient services,...

Core Measures Abstractor Join the American Data Network family and become part of an established, purpose-driven healthcare quality organization with more than 30 years of experience. At ADN, our work supports hospitals and healthcare...

Description There's nothing more exciting and rewarding than being able to make a significant, positive difference in someone's life. At UCLA Health, you'll experience this joy every day while also enjoying the positive, supportive,...

Job Title Job Description Duties and Responsibilities include but are not limited to: Provides administrative and clinical leadership for the Referral Coordination Program (RCP), ensuring effective coordination of...

Nurse Disease Management II (US) Telephonic Nurse Disease Management II Sign-on Bonus: $2000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions,...

Summary The VA Greater Los Angeles Healthcare System (VAGLAHS), Surgery Service, is recruiting for a Nurse Manager to lead the Referral Coordination Program. The incumbent provides first-line supervisory oversight of clinical referral coordination...

Senior Specialist, Quality Improvement (Registered Nurse) Reason for opening: FTE support needed for "Q4 Push" to close Medicare/MMP gaps in care with member & community events Will this role be fully remote? Yes Are there...

Sentara Healthcare Integrated Nurse Case Manager Location: Manassas, VA Work Shift: First (Days) Overview: Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for Northern Virginia, VA. This is a...

Utilization Management Admissions Liaison RN II (Nights) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13180 Salary...

The Ambulatory Case Manager, RN is responsible for providing comprehensive care coordination and case management services to members, ensuring seamless...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plansis hiring for a Manager, Integrated Care Management- Nursing Facility/ HCBS / LTSS Waiver - Remote! ...

The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This includes conducting patient evaluations, managing admissions and informational visits, and ensuring timely...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

A healthcare technology company seeks a Care Transition Nurse to train AI models and ensure the medical accuracy of responses. The role offers flexibility, including full-time or part-time remote work, and pays $50+ per hour, with bonuses for...

A healthcare services provider is seeking a Nurse Liaison who will act as a pivotal communication link among injured workers, insurers, and care providers. This role requires a skilled nurse to coordinate care and ensure efficient treatment.