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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,...

Integra Partners seeks an experienced Utilization Management Nurse Supervisor to lead the UM nursing team, ensuring performance, accountability, and professional development. You will conduct regular 1:1s, manage performance reviews, and drive...

Your Role The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Field Nurse Case Manager - Glendale, CA Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose. Every...

Provide essential clinical and administrative support to a remote healthcare team across Canada. Manage laboratory results, pharmacy communications, referrals, and patient follow-ups. Requirements: Current...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Yoh, a Day & Zimmermann company, is seeking an Utilization Management Nurse Coordinator (RN) for a remote contract opportunity based in Fairfield/Redding, CA. Training is onsite for 3 weeks, then remote with regular weekday hours and one weekend...

Pay Package: Total weekly gross $ 2979 for 40 hrs Job Description: Tittle: RN Case Manager Location: Mission Hills, CA 91345 Duration: 13 weeks Guaranteed hours: 40 hrs Shifts: Day Job Description: Start Date:...

University Hospitals is seeking a Registered Nurse to collaborate with the health care team to coordinate admissions, continued stays, and level-of-care decisions. You will communicate with patients and families to ensure timely care and proper...

Emanate Health in Covina, CA, seeks a Utilization Review Nurse to evaluate medical records and determine medical necessity using policies and guidelines for urgent and standard reviews. You will document decisions and support claims reviews,...

JOB REQUIREMENTS: -Experience: 3 years acute care case manager experience -CA RN License -Certs: BLS -**FLU VACCINE (no exemptions)** Flu season starts September -Special Requirements: EPIC highly preferred. Due to nature of...

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...

Care Management Team Member The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Benefits: 401(k) Competitive salary Dental insurance Health insurance Paid time off Signing bonus Training & development Vision insurance Outpatient Case Management West Los Angeles VAMC 11301...

Lead complex care management for members with primarily physical health needs through comprehensive assessments, person-centered care planning, coordination, education, and ongoing monitoring. Support PHCO Case Management and collaborate with...

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare- Complex Spine Team) We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At...

Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

At UK King's Daughters, we're not just a healthcare facility - we're a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We're more than just a place to work; we're a place to...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Job Opportunity Seeking 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...

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We...

**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 for all product lines. Recommends and implements process...

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