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Job Description Additional Information About the Role The Answer Line provides after-hours exchange and nurse triage services for about 250 subscribing community pediatricians in St. Louis and surrounding areas. The exchange is a 365/24/7...

Description The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically based appeals between Providence Health and Services, California Region (PH&S) outside...

Job Title Remote Work from Home Job Details Location: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Nursing Schedule: Day Shift Employment Type: Full Time Position Summary: Responsible for...

The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Minimum...

City/State Newport News, VA Work Shift Multiple shifts available Overview: Sentara Health Plans is currently hiring an Integrated Nurse Case Manager in the Hampton and Newport News area of...

Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13077 Salary Range:...

Join Our Caring Community As a RN Care Manager, you will enjoy a true work-life balance with no night or weekend shifts. Reporting to the Manager of Care Coaching, you will support members enrolled in the Wisconsin Family Care Program...

Details Client Name CSMN - 8714015 - Inpatient Specialty Program Crisis Response Job Type Travel Offering Nursing Profession...

Clinical Claim Review Nurse 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...

Utilization Management Nurse RIHS Austin Regional Office - Austin, TX 78727 Overview Position Type Full Time Description Primary Responsibilities The Utilization Management Nurse will determine the...

Location Address: 9521 San Mateo NEAlbuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $27.92Maximum Offer $42.63 Summary: Build your Career. Make a Difference. Presbyterian is hiring a...

Details Client Name California Hospital Medical Center Job Type Travel Offering Nursing Profession RN...

We are recruiting for a mission-driven RN Educator, Clinical Documentation Integrity - Must Reside in Colorado to join our team! We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something...

About the job Remote | Nursing Clinical Review Expert - $65-$95/hour We are sharing a specialised part-time consulting opportunity for nursing professionals experienced in patient care, clinical monitoring, medication administration,...

Join Our Team at Mercy! Utilization Management for the assigned inpatient Care Management population. This position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety...

Nurse Practitioner Nurse Practitioners will work in collaboration with a dedicated clinical care team to provide evidenced-based care to a panel of patients. The clinical care team will work with the provider daily to drive better...

Nurse Navigator Join an innovative startup health plan based in Wisconsin that is revolutionizing healthcare and empowering companies to combat the relentless rise in healthcare costs. Our mission is to provide accessible, high-quality...

SIGN ON BONUS - $5,000 RELOCATION BONUS: (for those outside of San Diego County) - $5,000 - Bonus Available if Started prior to 06.31.2027 Job Announcement Position Title:...

Nurse Case Manager (RN) Hospitals on Incredible Health are actively hiring and accepting applications in the Los Angeles, CA area for the following position: Nurse Case Manager (RN). Nurses with experience in any of the following areas...

Details Client Name Adventist Health White Memorial Job Type Travel Offering Nursing Profession RN Specialty...

Managing a daily caseload of Long Term Care (LTC) claims, the full-time remote Registered Nurse Claim Manager will evaluate claims for eligibility, educate policyholders on coverage, and communicate with service providers to facilitate claim...

Remote - Candidate is required to reside in California. The RN School Support Manager is responsible for the clinical oversight of the designated medical care needs per the district contract. This oversight includes support of care...

Job Description Cedars‑Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News & World Report's "Best Hospitals 2024-25" rankings, as well as placed among the very best in...

Utilization Review Nurse Health Plans - Case Management US:NM:Alamogordo | Utilization Management | Full Time This position has a remote option for those living close and will be able to come into the hospital as needed.

Location Address: 2925 Chicago AveLoading DockMinneapolis, MN 55407-1321 Date Posted: June 15, 2026 Department: 16007319 Care Management Disease Management Shift: Day (United States of America)...