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Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

Centene is seeking a Supervisor of Utilization Management to lead the Prior Authorization, Concurrent Review, and Retrospective Review teams. This remote role is ideal for experienced nursing professionals looking to guide performance, compliance,...

HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and...

Case Manager RN Torrance, CA, United States Salary - $51.44 to $64.87 (US Dollar) Job Summary: Salary - $51.44 to $64.87 Experience: Requires Case Management (Care Coordination or Utilization Management) in...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Sedgwick is seeking a US Telecommuter RN Telephonic Case Manager for a full-time remote role. You will support injured workers, employers and providers, coordinating medical services and advocating for timely recovery and return-to-work.

Guidehealth is a fully remote organization seeking a Care Manager to guide patients and families through complex health journeys from a Louisiana base. You will combine clinical expertise with holistic care, coordinating medical, behavioral, and...

Ansible Government Solutions, LLC is recruiting multiple Remote Registered Nurse Case Managers to support the VA Office of Veterans Community Care. The role involves managing SEOC data, ensuring compliance, and reviewing provider and veteran...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Hone is a virtual medical clinic for men's/women's health, hormones, weight loss, and longevity.We are remote-first and fast-growing, focused on candid communication and joy.The Role:You will manage patient-doctor communications and clinical...

BHU Intake Nurse Coordinator (RN)Job Title: BHU Intake Nurse Coordinator (RN) - Per Diem: 1 shift per week, weekend availability requiredBase Rate: $41.73- $61.3512 hr. shifts- paid overtime after 8 hours, resulting in an average rate of $48.69 -...

A reputable healthcare staffing firm in Oregon is seeking a care manager specializing in phone communication with patients across all ages. The role involves coordinating care services, educating patients on their health conditions, and conducting...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of...

Molina Healthcare seeks six TX licensed RNs to work telephonically with Medicaid members across the state. Three roles require at least two years in behavioral health or substance abuse; the other three require two years in ICU/CCU/ED. Most duties...

Cardinal Health is seeking a Nurse, Individualized Care Management to coordinate medical treatments, deliver patient education, and bridge gaps between patients, providers and support systems to promote continuity of care. The role supports...

Sentara Health in Richmond, VA is hiring an Integrated Case Manager, RN to coordinate patient care across the continuum. This remote-friendly, full-time role requires in-person assessments and travel to Winchester, Leesburg, Alexandria, and other...

CommonSpirit Health seeks a Virtual Registered Nurse (RN) to deliver remote, patient-centered nursing care via telephonic and video interaction. You will perform comprehensive virtual assessments, identify nursing diagnoses, and guide patients...

Brighton Health Plan Solutions, LLC is seeking an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely in North Carolina. You will use evidence-based guidelines and internal criteria to determine...

UnitedHealth Group is seeking a Telephonic RN Case Manager to act as the primary contact for members with complex medical and social needs. You will conduct telephonic assessments, create person‑centered care plans, and coordinate services...

Working remotely in a full-time capacity, the RN Telephonic Case Manager will manage treatment plans for injured or disabled individuals, collaborating with healthcare providers and employers to facilitate effective recovery and return to work.Key...

Centene Management Company LLC is seeking a Licensed Practical Nurse to analyze prior authorization requests and determine medical necessity in New York. You will work with healthcare providers and the authorization team to ensure timely,...

A healthcare management firm is seeking an RN Care Management Coordinator – Compliance Specialist to ensure compliance with relevant regulations and standards. This remote position requires a minimum of five years of clinical experience, an...

BJC HealthCare is seeking a registered nurse to join a remote Utilization Review team. The role supports multiple hospital units with no patient communication, and it is designed for local remote work with weekend rotation. Responsibilities...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty:...

Spectrumforce Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for a 3-month contract to hire. The role is remote with work location listed as Remote-MS CST, schedule 8 am-5 pm Central time, with occasional weekend...