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About This Role The Care Manager (RN) will support Michigan Medicaid members with complex medical needs through telephonic outreach, health assessments, and care plan development. This role is ideal for those with experience in case...

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...

About the Job Job Description: All Care Home Health is currently seeking a Licensed Vocational Nurse (LVN) Care Coordinator to join our team supporting the Kaiser region. We...

Job Summary: Under the direct supervision of a Registered Nurse or physician, performs a variety of patient care functions as assigned and in accordance with the legal scope of competency and within established standards of care, policies...

CVS Health is seeking a Registered Nurse to support Utilization Management in a remote-friendly role. You will apply clinical judgment to ensure appropriate services, coordinate with providers, and support care decisions in a fast-paced,...

Join Gainwell It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career...

Telephonic Care Manager Are you an experienced nurse with a background in case management? Are you interested in the opportunity to work from home? UPMC Health Plan is looking for you! We are hiring a full-time Telephonic Care...

Pain Management Nurse (Home Health) – Enhancing Comfort & Quality of Life for Seniors All Seniors Foundation is dedicated to improving comfort and quality of life for elderly patients. Effective pain management is a cornerstone of our...

Case Management Utilization Management Great care starts with great people. (Like you.) At HonorHealth, you'll find something special. From humble beginnings in 1927 to one of Arizona's largest nonprofit healthcare systems, our...

Medication Nurse - Substance Use Disorder Treatment CRI-Help is a substance use disorder treatment center with several locations across Los Angeles County. We've been around since 1971 and are noted as an organization practicing integrity...

Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

NirvanaHealth Utilization Management Nurse Join us in our mission to transform healthcare! NirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees...

School Nurse St. Paul the Apostle School is deeply committed to serving children and plays a critical role in supporting the health, wellness, and academic success of our students. Our mission goes beyond academics—we provide holistic...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

Utilization Management Nurse The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The role includes...

Description The UM Denial Nurse Reviewer supports high-quality, cost-effective care by applying clinical knowledge, policies, and regulatory guidelines to the review and processing of adverse organization determinations. This role reviews...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management) .Candidate must be authorized to work in USA without requiring sponsorshipLocation: 100% Remote for California...

School Nurse Under direction, to provide basic health services to students; to assist in the planning and implementation of school health programs in cooperation with medical authority and school administrative personnel; to evaluate the...

About Sunnyside Nursing Post-Acute Care Centrally located in Torrance, California, Sunnyside Nursing and Post-Acute Care provides sub-acute nursing care, rehabilitation services, skilled nursing, and long-term care.

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty:...

Job DescriptionJob DescriptionLVN Inpatient Case Manager – Utilization Management Position DetailsPay Rate:$33–$46 per hourLocation:Montebello, CA 90640 (Onsite)Schedule:Monday–Friday, 8:00 AM–5:00 PMAssignment Type: TemporaryAssignment...

About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors...

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...

JWCH Mission Statement: The Mission of JWCH Institute is to improve the health status and well-being of under-served segments of the population of Los Angeles Area through the direct provision or coordination of health care,...

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...