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nTech Workforce seeks a HEDIS Clinical Review Nurse to support an annual HEDIS retrospective project. You will drive medical record retrieval, abstraction, provider outreach, and quality measure management in a team focused on compliance and...

Job Summary Works 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 medical...

Nurse Care Manager We're looking for Nurse Care Managers for our Care and Case Management team, who are passionate about caring for members holistically through their healthcare journey and ensuring needs are met with industry-leading...

UnitedHealthcare is seeking an RN to assess, plan, and implement person-centered care strategies for members in the Harris County area. The role offers remote work flexibility with substantial travel responsibilities within the region.

Care Manager Registered Nurse (CMRN) At Hopscotch Primary Care, we believe great healthcare should be accessible to all people across all communities. Today, almost 20% of Americans live in a rural community, yet only 11% of physicians...

CVS Health is seeking an experienced Registered Nurse for Utilization Management. This 24/7 role requires clinical expertise to assess and coordinate care, determine coverage and promote optimal health outcomes. You will engage with...

Optum is seeking an experienced Behavioral Health Integration Nurse Case Manager to serve as a clinical liaison between OptumCare/Care Delivery and the clinical network. This role coordinates assessments, plans, and services to meet members'...

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.

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...

To support timely and compliant care decisions, the full-time Utilization Management Nurse RN will review medical necessity requests, apply evidence-based criteria, and document determinations while working Monday to Friday, 8:00 AM-5:00 PM...

Elevance Health is seeking a Nurse Case Manager I to perform telephonic and on-site care management for members with complex needs. The role supports discharge planning and requires licensure and clinical experience. This position...

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,...

CorVel Corporation is seeking a caring, self-motivated Registered Nurse to fill a Medical Case Manager role covering Newnan, Columbus, LaGrange, Fayetteville, Stockbridge, Metro ATL and surrounding areas in Georgia. The position blends...

UnitedHealth Group's Optum Care at Home team is seeking a Telephonic RN Case Manager in Washington. You will conduct telephonic assessments, develop person-centered care plans, and coordinate transitions across Medicare and Medicaid services while...

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults-and we're looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living...

Supervisor of Utilization Management (UM) RNSalary Range: $102,183.00 (Min.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to...

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...

Job Details Job Location: COLUMBUS, OH 43213 Position Type: Full Time Salary Range: $57,648.00 - $81,051.00 Salary Summary: The RN Care Coordinator - Remote Patient Monitoring (RPM) functions as a registered nurse...

JOB SUMMARY: The care management staff that KPPC employs are all state-licensed Registered Nurses or Licensed Social Workers. These professionals all have thorough knowledge of North Carolina patient resources and...

Title: Clinical Review Nurse Concurrent Review Location: Remote Duration: 12 months (Potential Extension) Schedule: Mon-Friday, 11AM to 8pm CST; Weekends and Holidays on a rotation basis based on...

CSI Pharmacy is seeking a Regulatory and Compliance Nurse to lead employee health programs across states, ensuring TB screening, immunization tracking, and regulatory adherence under OSHA/CDC guidelines. The role involves collaboration with...

Collaborative Practice Nurse (CPN) Blue Ridge Cancer Care is seeking an experienced and highly motivated Collaborative Practice Nurse (CPN) to support oncology patients across the continuum of care. The CPN serves as a clinical resource...

Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform-bringing health plan administration, holistic...

AmTrust Financial Services Inc. is seeking a Telephonic Medical Case Manager, RN, to deliver comprehensive remote case management in Texas. You will drive medically appropriate return-to-work through collaboration with injured employees, providers...