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CVS Health in Florida is seeking a Utilization Management Nurse Consultant who will review and coordinate care for members, applying medical necessity criteria and evidence-based guidelines. This full-time, work-from-home role supports 24/7...

Sedgwick is seeking an RN Field Case Manager to work face to face with injured workers and medical providers, supporting advocacy, expedient treatment, and return-to-work efforts. The role blends remote work with necessary in-person interactions...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...

Nurse (RN) - Case Manager Hours are as needed, Monday - Friday during business hours; you will work 4, 8 or 10-hour shifts as needed to fill gaps in staffing. Hours can also include weekends but not required. This position is remote.

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

Overview At Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in the United States,...

Centurion Health is seeking a Full-Time CQI Specialist for our Regional Office team. This remote/traveling position requires residing in Northern Illinois with a commutable distance for site visits (2-4 days/week) and occasional travel to...

Registered Nurse Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Evenings Job Description Join a team that's shaping the...

Job Summary and Responsibilities As our RN Care Coordinator, you will be a central figure in patient care, seamlessly navigating the healthcare journey to achieve optimal outcomes and an exceptional patient...

Providence is seeking a Care Manager Appeals RN for a remote per diem role in California. The position supports denial appeals and reimbursement for services, with 8-hour day shifts. The CMRA will manage and communicate clinical appeals...

Sagility is seeking an experienced Registered Nurse for a Senior Care Specialist role that can be performed from home. The position involves telephonic health assessments, care planning, and education to Medicare, Medicaid, or group plan members.

Registered Nurse - Compliance Partner Position Type: Full Time, Employee. Salary: $110,000 to $120,000 annually, DOE. Location: This is a field-based position that requires regular travel to...

Anchor Health Registered Nurse Are you looking for a workplace where you can make a genuine difference? Company culture that feels supportive, genuine and appreciative of all? Anchor Health is committed to the communities of which we...

Optum UT is seeking a Skilled Nursing Facility (SNF) Case Manager to join our team in Draper, UT. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery...

SHIFT: Any (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will...

Job Description This position offers a blend of on-site and remote work, along with a $5,000 sign-on bonus for eligible new hires. If you're an experienced...

PRN Assessment Nurse The PRN Assessment Nurse is responsible for identifying current and future patient care needs; being able to recognize normal versus abnormal body physiology. The role requires critical thinking, attention to detail...

Job TitleFacilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS. Reviewing paper and electronic...

Utilization Management Admissions Liaison RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide health...

Registered Nurse - Compliance Partner Salary: $110,000 to $120,000 annually, DOE. Location: This is a field-based position that requires regular travel to assigned facilities. Candidates must live within close proximity to a major airport...

We are so glad you are interested in joining Sutter Health!Organization: SHSO-Population Health Services-UtahPosition Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and thorough intake services by...

The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...

Humana is seeking a Field Care Manager Nurse 2 to assess and guide members toward appropriate care resources, focusing on physical, environmental, and psycho-social health. You will report to the Manager, Care Management and support partners...

HCBS Utilization Management Nurse $5,000 Sign-on Bonus for External Candidates This position is open to candidates who live in DC, MD, or VA This position is based in the greater Washington D.C. area. Standard Hours:...