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Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through...

University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and...

Care Management Coordinator/RNLocation: 100% Remote Duration: 3+ Months (FT conversion)This is a Utilization Management RN part time position - working every other weekend (2 days a week in a 2 week cycle). Must be available M-F 8:30-4:30pm for...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

Cadence in Seattle is seeking an RN Supervisor to oversee a remote team of Registered Nurses in a high-volume triage environment. The role entails managing real-time patient alerts and ensuring clinical quality and operational performance. With a...

UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient criteria, preauthorizations, and ensuring medical necessity while applying evidence-based...

Optum is seeking an Inpatient Care Management Nurse to assess and interpret member needs, guiding utilization of health services to improve outcomes. You will collaborate with clinicians, perform case reviews, and support discharge planning from...

Santa Barbara Cottage Hospital is seeking an experienced Utilization Management Nurse Consultant for a remote role with the Spine Team. You will review spine-related authorizations, apply criteria, and collaborate with providers and Medical...

A leading healthcare company is seeking a Tele-Health Nurse to provide high-quality service for specialty prescription drugs. This role includes case management and patient coordination. Ideal candidates should possess a Vocational or technical...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

A healthcare services provider in Cleveland, Ohio, is seeking a Case Manager Nurse Advocate. This position offers remote work flexibility and requires an active nursing license and a Bachelor of Science in Nursing (BSN). The ideal candidate will...

Clinic Licensed Vocational Nurse I/Licensed Vocational Nurse I This opportunity is open to everyone. Applicants from all backgrounds and organizations are welcome to apply. We are looking for the best talent to join our...

Job Description: The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing...

Overview CORE Health Networks, the recognized leader in Integrated Occupational Medicine Services, provides integrated solutions to your occupational healthcare needs. We are currently seeking a full-time Case Manager (Registered Nurse)...

Owning the development and execution of Leap's Quality Assessment and Performance Improvement (QAPI) program, the full-time Remote Registered Nurse Quality Manager will ensure high-quality care delivery across all partner networks, manage clinical...

Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS -...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

Job OpportunitySeeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the opportunity...

Mist Registered Nurse (RN)Organization: SHSO-Population Health Services-UtahPosition Summary: The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical...

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

A healthcare solutions provider is looking for a qualified RN to perform medical reviews and coordinate care for members. This role involves assessing service needs, engaging in patient education, and ensuring compliance with healthcare...

Your future role at a glance Location: Pensacola, FL | Remote Facility: Ascension Sacred Heart Department: Clinical Integrity Documentation Schedule:...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...

Broadway Ventures, a veteran-owned SDVOSB headquartered in Mississippi, seeks an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud referrals. You will apply clinical expertise...