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GQR Healthcare is seeking a local contract nurse RN Case Management for a local contract nursing job in Woodland Hills, California. Job Description & RequirementsSpecialty:...

TriWest Healthcare Alliance is seeking a Utilization Management Clinical Review nurse to assess medical necessity and manage prior authorizations for Behavioral Health and Medical/Surgical requests. You will apply InterQual criteria, document in...

Deliver comprehensive nursing care using the nursing process, including assessment, planning, and evaluation.Monitor patient conditions, adjust care plans, and collaborate with the team to improve outcomes.Requirements:Active RN license, BLS...

Devoted Health is seeking a Clinical Guide for our Outpatient Utilization Management team. You will perform clinical reviews of outpatient authorization requests, applying evidence-based criteria and CMS requirements to ensure appropriate care...

About the opportunity: Vail Health has become the world's most advanced mountain healthcare system. Vail Health consists of an updated 520,000-square-foot, 56-bed hospital. This state-of-the-art facility provides exceptional care to all of...

Kintegra Health in Gastonia, NC seeks a Telephonic Triage Nurse Manager to lead telephonic triage services, supervise nursing staff, and ensure safe, timely, patient-centered care for adults and children. Reporting to AVP-Nursing, you will shape...

Ways2Well is seeking a Nurse Manager to lead a remote clinical support team, drive patient service excellence, and uphold clinical standards. The role focuses on coaching, performance management, and continuous improvement across workflows.

HCSC is seeking a remote QOC Nurse under the supervision of the QOC Manager to conduct review and investigation of quality of care issues. The role supports quality improvement activities in compliance with CMS, NCQA and other regulatory...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Service Excellence Manager - RN (Remote) Clinical Operations - Neurology...

Enlyte is hiring a Telephonic Case Manager. The role requires an active NJ RN or LPN license and allows full-time, remote work from the Eastern Time zone. You will collaborate with treating physicians, employers, and injured individuals to...

The University of Texas MD Anderson Cancer Center is seeking a Denials Management Coordinator to support revenue cycle operations by coordinating review, analysis, and resolution of insurance denials and to help secure accurate reimbursement. This...

Metropolitan Transportation Authority seeks a Manager, Nurses to lead nursing and technical staff across NYCT, LIRR, MNR, and B&T sites. You will coordinate projects, ensure quality control, and support vaccination, surveillance, and safety...

Back RN/Managed Care Coordinator (Remote) Healthcare Columbia , South Carolina Contract Hybrid Nov 10, 2026 RN/Managed Care CoordinatorJob at a GlanceTitle: Managed Care...

Case Manager RNParamount, CA$2425 /Weekly Gross**Estimated pay package. Does not include taxes, insurance, or other deductions that may occur8H Days13 Weeks40Long Term Acute Care Hospital165Proprietary SoftwareRequirementsAt least 2+ years'...

Mary Washington Healthcare Incorporated is seeking a Level II Registered Nurse for a Virtual Registered Nurse (VRN) role. The VRN provides professional nursing care via two-way audio/visual technology, conducts virtual assessments, and...

Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal...

CareHarmony is hiring a Licensed Practical Nurse (LPN) in Oklahoma City to join their team in delivering value-based care management. The role involves conducting health assessments, coordinating resources for chronic care, and educating patients.

Health & Human Services in North Carolina seeks a Nurse Consultant I (NS) to perform regulatory nursing home inspections, ensuring compliance with federal and state requirements and preparing deficiency reports. The role is home-based with regular...

Manage patients assigned to your Care Team, ensuring visit frequencies align with acuity levels. Communicate via phone and video conferencing, assess and enroll patients, and develop care plans. Manage medications,...

Centurion Health is seeking a Full-Time CQI Specialist for our Regional Office team. This remote/traveling position requires residing in Northern Illinois with a commutable distance for site visits (2-4 days/week) and occasional travel to...

Conduct telephonic nursing assessments and triage using protocols.Provide health education and referrals to diverse patient populations.Work Schedule:Full-time evenings with weekend shifts every two weeks.Virtual training for 2-4 weeks, 100%...

Full-time Company Description WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

Nascentia Health is seeking a Care Manager to provide care management for health plan members, create PCSP, coordinate services, and document care per plan standards. This is a remote-first role, Monday–Friday, 8:00 AM–4:30 PM. This...

Health & Human Services in North Carolina seeks a Nurse Consultant I (NS) to perform regulatory nursing home inspections, ensuring compliance with federal and state requirements and preparing deficiency reports. The role is home-based with regular...

Sedgwick is seeking an RN Telephonic Case Manager to support injured workers remotely. You will partner with workers, employers, and medical providers to develop care plans that promote medical recovery and a successful return to work. The...