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Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care...

Sedgwick is hiring a Telephonic Case Manager (US Telecommuter) to support injured workers by planning medical care and advocating for timely returns to work. You will assess needs over the phone, coordinate services, and communicate with care...

The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...

HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

Company : Highmark Inc. Job Description :JOB SUMMARY This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction...

Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges.

Overview Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Job Details Field Nurse Case Manager (Remote) 2026-1480 Bethesda, Maryland, United States Medical Case Management Full Time Description Overview Are you looking to make a difference by...

Guidehealth, a data-powered healthcare company, is seeking a licensed RN Case Manager to work remotely from Wisconsin. You will collaborate with clients and members to promote wellness, navigate the health system, and manage case assignments from...

WNS Healthhelp in the United States is seeking an RN/LVN Team Lead to oversee utilization management and case coordination. You will balance review work with leadership duties, monitor staffing, and ensure regulatory compliance across programs.

Registered Nurse (RN) - Utilization Management Location: Remote in NJ Job Duration: 3 months contract (possible extension) Schedule: Regular Business Hours Pay Rate: $40/hr. on W2 Job Description: ...

CVS Health Corporation in the United States is seeking a Utilization Management Nurse Consultant to coordinate, document, and communicate all aspects of the utilization/benefit management program. This 100% remote role requires applying clinical...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Ansible Government Solutions, LLC is recruiting multiple Remote Registered Nurse Case Managers to support the VA Office of Veterans Community Care. The role involves managing SEOC data, ensuring compliance, and reviewing provider and veteran...

Registered Nurse (RN) - PRN/Not Remote Rivendell Behavioral Health Servicesis an 80-bed full-service behavioral healthcare acute care facility located in Benton, AR, that has been providing quality health care to the residents of Arkansas...

Humana is seeking a Telephonic Care Manager to support a remote case management program. You will coordinate care across sites and levels of care, leveraging resources to prevent readmissions and ensure integrated, compliant care plans for...

Admissions Nurse Location: USC Arcadia Hospital Schedule: Tuesday - Saturday, 12pm - 8:30pm Salary Range: $50 - $55 / Hourly Why Hospice? Why VITAS? Have you ever considered hospice as a...

UnitedHealth Group's Optum Care at Home is seeking a Telephonic RN Case Manager to serve as primary contact for members with complex medical, behavioral health, functional, and social needs, coordinating care across Medicaid LTSS, home health, and...

Position Title: Remote Telephonic RN Case Manager Mandatory Requirement: Must hold an Active Compact RN License and/or an Active California (CA) RN License to be considered. Pay Rate: $48.00 – $50.00 per hour...

A reputable healthcare staffing firm in Oregon is seeking a care manager specializing in phone communication with patients across all ages. The role involves coordinating care services, educating patients on their health conditions, and conducting...

Cardinal Health is seeking a Nurse, Individualized Care Management to coordinate medical treatments, deliver patient education, and bridge gaps between patients, providers and support systems to promote continuity of care. The role supports...

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...