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Job Description This position offers a blend of on-site and remote work, along with a $5,000 sign-on bonus for eligible new hires. If you're an experienced...

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people...

Sedgwick is hiring an RN Telephonic Case Manager. This remote role supports injured workers by evaluating medical needs, coordinating care, and advocating for timely recovery and return to work. You will work with employers, providers, and...

Registered Nurse (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

CVS Health is seeking an experienced RN Utilisation Management Nurse Consultant to support Medicare joint procedures. This remote, full-time role focuses on ensuring appropriate care, coordinating plans, and applying evidence-based criteria for...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

NaphCare is seeking an experienced Utilization Management Registered Nurse for a remote-based position supporting an Arizona team. NaphCare delivers healthcare to correctional facilities nationwide and offers strong benefits and professional...

The Delegation Oversight Compliance team is responsible for working with appropriate departments in the areas of compliance, process improvement, and member/provider satisfaction for all product lines. Reviews, research and responds to customer...

CareHarmony's Care Coordinators (LPN) (NLC) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced Licensed Practical Nurse – LPN Nurse (LPN)...

Salary : $101,190.00 - $151,468.56 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: Y5134L Department: HEALTH SERVICES...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Open Non-Competitive Job Opportunity Exam Number: Y5134L First Day of Filing: 3/3/2026, 8:00 A.M., PT, until the needs of the service are met and is subject to close without prior notice. COVID-19 Vaccination Mandate: All...

Telephonic Nurse Case Manager II Telephonic Nurse Case Manager II Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and...

Job Description Clinical Quality Assurance Nurse (RN/LPN) - Remote | $26.50/hr Title: Clinical Quality Assurance Nurse (RN/LPN) - Remote Location: Remote (U.S.-based)...

Company Description WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services,...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Job Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members. Providence caregivers are not...

RN Career Transition Opportunity – Nurse Case Manager Are you an RN seeking a rewarding career shift that uses your clinical skills and compassion — without the physical demands of bedside care? QuestPro has the exclusive...

Job ID: 28177 *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,...

Company OverviewAcentra 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 rallying cry at...

Job Summary and ResponsibilitiesAs our Educator in Critical Care Emergency, In accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a consultant/resource...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...

Description RN- Registered Nurse - Case Manager Specialty: Case Manager Location: Los Angeles,CA,00000 Start Date: 2026-10-19 End...