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Sentara Health in Richmond, VA is hiring an Integrated Case Manager, RN to coordinate patient care across the continuum. This remote-friendly, full-time role requires in-person assessments and travel to Winchester, Leesburg, Alexandria, and other...

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 sponsorship...

Molina Healthcare Illinois Virtual Hiring Event Molina Healthcare is looking for dedicated Care Managers (RN, LPN, BH licensed) across Illinois to provide compassionate, coordinated care to our members. Join a team committed to improving...

Humana Inc. is seeking a Telephonic Nurse Care Manager to assess and coordinate care for members remotely in South Carolina. This role emphasizes telephonic assessments, care planning, education, and resource coordination to support optimal...

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...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

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...

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.

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...

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...

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...

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.

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...

Medix is seeking a Remote Telephonic RN Case Manager to provide telephonic case management for chronically ill members within a C-SNP population. The role requires an active Compact State RN license or CA license and a strong commitment to patient...

UnitedHealth Group is seeking a Telephonic RN Case Manager to act as the primary contact for members with complex medical and social needs. You will conduct telephonic assessments, create person‑centered care plans, and coordinate services...

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 Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

Guidehealth is a fully remote organization seeking a Care Manager to guide patients and families through complex health journeys from a Louisiana base. You will combine clinical expertise with holistic care, coordinating medical, behavioral, and...

Employment Type: Full time Description: Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices &...

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...

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...

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,...

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...

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately...