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The Clinical Case Manager functions within the multidisciplinary team to facilitate an assigned group of patients through the health care system with the primary focus of efficient, effective, compassionate inpatient care and a safe transition to the...

A healthcare organization in California is seeking a Case Manager, RN to guide participant care in a collaborative environment. The role focuses on comprehensive care for seniors, requiring a nursing degree and California RN license.

A nonprofit health plan is seeking a Quality Outreach Case Manager to improve healthcare outcomes for members through proactive engagement and care coordination. This remote position involves conducting outreach to address member needs, providing...

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 with the care, pharmacy benefits, data...

A leading healthcare organization seeks an experienced individual to manage utilization review processes remotely. This role requires a Registered Nurse with leadership experience to oversee operations and collaborate with medical teams to ensure...

Care Manager, RN - ECM, Riverside 3 (Remote with field work) Join to apply for the Care Manager, RN - ECM, Riverside 3 (Remote with field work) role at IEHP 1 day ago Be among the first 25 applicants What you...

Registered Nurse Disease Managers (RNDM) Spectrum Healthcare Resources has an opportunity for a Registered Nurse Disease Managers (RNDM). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be...

Remote Utilization Management Nurse Job Description As a Utilization Management Nurse for Post Acute care, you will be responsible for reviewing and documenting prior authorization and concurrent...

Similar experience is needed. RN license, required. Position Overview The Home Health RN Document Integrity Specialist is responsible for all quality assurance related external audits in adherence with regulatory standards. Work from home, remote...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities, ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Nurse Navigator 1 - Site Disease - Full Time/Remote page is loaded## Nurse Navigator 1 - Site Disease - Full Time/Remotelocations: Miami, FLtime type: Full timeposted on: Posted Todayjob requisition id: R100091779## **Current Employees:**If you...

Job Description Job Summary The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies...

A healthcare service provider is seeking a Registered Nurse - Case Review Specialist to provide remote support in reviewing cases for Federal Occupational Health. The ideal candidate will have at least 5 years of Nursing experience, a valid RN...

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 healthcare services company is seeking a Nurse for Individualized Care in Boston. This role emphasizes high-quality patient education and support for treatment management. The Nurse will conduct inbound and outbound calls, providing crucial...

Overview Remote Registered Nurse (RN) – Nurse Triage System Staffing Office Float, Full-time Position Summary The RN – Nurse Triage provides high-quality, patient-centered care through telephone triage and clinical...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Pyramid Consulting (Travel) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

A leader in medical examination services is seeking a Remote Clinical Quality Assurance Nurse Auditor. This role requires a Registered Nurse with critical care and ER experience. Responsibilities include evaluating clinical information, performing...

Clinical Appeals Rn At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come...

A leading risk and claims administration company is seeking a part-time nurse to join their team in Annapolis. This role involves triaging medical calls to assess needs and offering appropriate care solutions. The ideal candidate should hold a...

Scope of Position The Clinical Case Manager functions within the multidisciplinary team to facilitate an assigned group of patients through the health care system with the primary focus of efficient, effective, compassionate inpatient...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

JOB DESCRIPTION Job Summary The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure compliance...