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About Us One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn't your average...

UnitedHealthcare seeks a Manager of Clinical Annotation to lead a team of RN Clinical Annotators responsible for labeling and validating medical data used in AI-powered prior authorization automation. This role combines clinical leadership,...

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the...

Vaya Health seeks a Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical necessity. You will reference standardized criteria and coordinate with physician peers when needed. This role is part of a...

***NOTE: THIS IS A PRIMARILY REMOTE POSITION THAT ONLY REQUIRES ONSITE WORK QUARTERLY*** Summary: The Senior Risk Management Consultant will provide a broad range of administrative, facilitation and...

UnitedHealthcare is seeking an RN Care Manager to work remotely within Mecklenburg County, NC. In this role you will assess and plan individualized care, coordinate referrals, and advocate for members to ensure access to appropriate services.

PURPOSE AND SCOPE: Functions as the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Provides day to day direction and...

Upper Peninsula Health Plan (UPHP) is seeking a Remote Community Based Clinical Coordinator - Care Manager. This full-time role supports UPHP members across Western Upper Peninsula counties, with travel to member homes and UPHP headquarters in...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

Description RN - Quality Assurance located at Providence Willamette Falls Medical Center (primary location) and Providence Milwaukie Hospital (secondary location), with rare travel to Providence Newberg Medical Center. The position does not...

SRN This position represents 5 openings. Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in...

WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of...

UnitedHealth Group is seeking a Manager of Clinical Annotation to lead a team of Registered Nurse Clinical Annotators responsible for labeling and validating medical data used to train AI models for prior authorization automation. The role...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

UnitedHealthcare is seeking a Manager of Clinical Annotation to lead RN Clinical Annotators in labeling and validating data for AI-driven prior authorization. You will guide clinical standards, ensure data quality, and partner across data science,...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

Overview: Mountain Ridge is HIRING MDS Coordinator Flexible Schedule - Full time OR Part time This is not a remote role, onsite is required Offering $10,000 Bonus We are dedicated to improving the lives we touch through the delivery of...

UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services, assess member needs, and identify plans of care. This role supports collaboration with care teams and compliance while offering...

A prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case management, understanding of regulatory compliance, and the...

The Triage Registered Nurse is responsible for identifying and coordinating patient/family needs and for providing preventive and supportive care to the terminally ill patient/family unit. The Triage Registered Nurse provides continuity of care to...

CVS Health is seeking a Clinical Quality & Compliance RN for a remote role focused on quality, compliance, and operational excellence. You will ensure utilization management processes meet regulatory, accreditation, and quality standards,...

Premera is a health plan seeking a licensed RN for a Care Coordinator - Clinical Appeals role. You will review inpatient, concurrent, and retrospective requests to determine medical necessity and appropriate care across plans. You will...

Centene is seeking a licensed Practical Nurse or Registered Nurse for a remote utilization management role based in Oklahoma. You will review prior authorization requests for medical necessity and coordinate with medical teams to ensure...

Working as a Nurse Case Manager at Cunningham Childrens Home means youll be part of team that is dedicated to supporting youth in critical need of emotional, psychological, and physical care. Located in Urbana, IL, Cunningham Children's Home is a...

Description 3 years of recent ED registered nurse experience strongly preferred. 1 years of recent leadership experience strongly preferred. Location: UCHealth UCHlth Emerg Aurora Central, US:CO:Aurora Department: Aurmiss Free Standing ED Work...