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It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

At St. Luke's, our dedicated team of Remote Patient Management RNs are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which...

Job Summary Provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical...

The Manager of Utilization Management (UM) is responsible for the operational leadership, compliance oversight, and performance management of Utilization Management programs across assigned contracts and lines of business. This role ensures UM...

As our Telephonic Nurse Care Manager, you will coordinate all aspects of patient care for high-risk individuals. You will evaluate each patient while directing treatment plans, discuss claims, benefits, and eligibility, and manage resources while...

The Student Nurse is responsible for providing a variety of direct and indirect patient care activities as supervised and directed by the Registered Nurse. Care is provided in collaboration with the patient, family, and other members of the patient...

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

remote within one of our plan states, IL, TX, NM, OK, MT or TN Registered Nurse responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and promote...

POSITION DESCRIPTION JobTitle: Wellness Nurse Supervisor:Health Services Director FLSAStatus:Hourly,...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

Job Type Full-time Description WESTSIDE IS LOOKING FOR A NURSE / RN TO JOIN THE VIRTUAL NURSE TEAM! SIGN ON BONUS OFFERED! LOAN PAYOFF PROGRAMS...

Job Description: Sharecare is a digital healthcare company that delivers software and tech-enabled services to stakeholders across the healthcare ecosystem to help improve care quality, drive better outcomes, and lower...

Job Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our...

Summary We are currently hiring for a Quality Nurse Navigator to join BlueCross BlueShield of South Carolina. In this role as a Quality nurse Navigator, you will monitor/implement quality improvement/management activities,...

Job Description The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families...

Registered Nurse, Quality Assurance Reviewer The Registered Nurse, Quality Assurance Reviewer will work in conjunction with the Quality Manager and will be responsible for completing quality reviews for the Clinical Services and Provider...

Join the Team at Concierge Home Care - Where Care Changes Lives! At Concierge Home Care, we believe in the power of home health care to change lives-for patients and team members alike. Our mission, "Caring for people who...

Job Description: Seeking a Registered Nurse to serve Essentia Health on a casual, as-needed basis in our Utilization Management department. This job is fully remote. To qualify for this position, an RN must have a minimum of...

JOB DESCRIPTION Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member...

A healthcare organization in Montana seeks a fully remote Utilization Management Specialist responsible for reviewing admissions, ensuring compliance, and collaborating with healthcare providers. The ideal candidate is an RN or Social Worker with...

HJ Staffing is partnering with Impresiv Health, a specialized healthcare consulting partner, to find a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN). This critical...

Nurse Case Manager Position Type: Full-Time Contract Role Location: Work from home Work Type: Remote Est. Pay Range: $35.00/hour $38.46/Hour on W2 (USD) (all inclusive) Schedule: Mon-Fri 8am-5pm EST...

Job Type Full-time Description About Us Hines is a nationwide, independent leader in personalized managed health care, focused on what's important to you-comprehensive services with the program...

Description Role Snapshot Our Case Management RN (Registered Nurse) coordinates care and services of select member populations with complex health care needs across continuum of care. The...

Hiring Now for RN Case Manager/Utilization Review Department: Case Management Shift: Full-time Hybrid Job Summary: The RN Case...