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Job ID: 32989 *Description*In this role, you will manage nursing clinical practice and oncology care processes to ensure optimal patient outcomes and high standards of clinical practice. You will implement changes to patient workflows and...

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...

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...

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...

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,...

Quality Assurance Specialist (QA RN)Pay Range: $40 - $50 per hourJob Type: Part TimeLocation: RemoteJob Summary Buena Vista Home Health is seeking an experienced OASIS Review Nurse (Registered Nurse – RN) to support clinical quality, regulatory...

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 Summary and Responsibilities* As our Nurse Shift Manager, you'll oversee a department of frontline nurses caring for patients. Every day you will advocate for your fellow nurses as you support them in reaching their full potential,...

CVS Health is seeking a Utilization Management Nurse Consultant to operate in a remote capacity from New York. This role supports a 24/7 utilization management team with weekend, holiday, and evening shifts, coordinating care decisions and...

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...

Public Consulting Group is seeking a Client Success Partner for EDPlan Health. You will manage relationships across states, deliver training, and lead client engagements focusing on school nurse EHR workflows. The role blends nursing...

CVS Health is seeking an RN in New Jersey to support Utilization Management. The role involves assessing and coordinating care, applying clinical criteria for coverage decisions, and collaborating with providers and teams. The position...

Humana, Inc. is seeking a Behavioral Health Nurse for Utilization Management, coordinating medical services and benefit determinations in a remote-capable role based in Indiana. You will interpret criteria and policies to support member...

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...

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...

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...

Saint Alphonsus Health System is seeking a Peer Review Coordinator to manage data collection, analysis, and reporting for performance improvement and physician peer reviews. You will coordinate with Medical Staff Office and Risk Management while...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end...

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...

WPS Health Solutions is seeking a Case Management RN to coordinate care for members with complex health needs. You will develop and monitor member-centric plans, educate members and families, and liaise with providers to ensure high-quality,...

Care Manager Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will...

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...

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...