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Who is Nest Health? As the first value-based care provider built for families, Nest is on a mission to make comprehensive medical, behavioral, and social care radically accessible to America's highest risk families. Founded...

Job Description Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant, pediatric,...

Job Responsibilities: The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and...

Job Details Sr. Performance Improvement Program Manager (RN) Monday-Friday - (Day Shift) Newark DE ChristianaCare is seeking a Senior Performance Improvement Program Manager (RN) to join our...

Job Type Full-time Description *This position requires 4-5 days/week onsite at either JHH or Saint Agnes* Summary/Position Objectives: This position is responsible for the planning,...

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...

Job Description Title: Utilization Management Nurse - Post Acute Location: Remote | Candidates must reside within Minnesota or Wisconsin Job Type: Contract (3 months)...

Job Opportunity At Highmark Inc. Job Summary: This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource...

Scope of Position The Supervisor is primarily responsible for administering nursing operations within The James Cancer Hospital and Research Institute during off-shift hours including weekends and holidays. The Administrative Nursing Supervisor is...

Company Details Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is...

About Outpatient Clinics Corewell Health operates over 300 outpatient clinics across Michigan, bringing a multitude of care options to the communities that we serve. There are over 40 different types of primary care and specialty...

Admissions Nurse Salary Range: $40 - $42/Hourly Why Hospice? Why VITAS? Have you ever considered hospice as a clinical specialtyone that blends clinical expertise with deep human connection? Just like cardiology or...

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people...

Company Navitus About Us Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing...

City/State Fairfax, VA Work Shift First (Days) Overview: Sentara Health in Woodbridge, VA is looking to hire an Integrated Case Manager, RN. This is a remote position; however,...

Available on provided telephonic platform, both taking and placing calls to coordinate and manage care for members between care givers, facilities, hospitals, primary care providers and the Optum field colleagues. Available to use video platform...

A healthcare organization is seeking an RN Coordinator Utilization Management to evaluate prior authorization requests, ensuring compliance with guidelines while collaborating with healthcare providers. This full-time position requires candidates...

Summary: The Rare Disease Specialist is responsible for representing TerSera products in hospital accounts and targeted clinics. They will be responsible for effectively presenting clinical information and gaining interest...

JOIN TEAM TRILOGY: At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of long-term care, competitive...

SUMMARY: Promotes the development of high quality patient care in the most effective setting, balancing patient/hospital advocacy. Knowledgeable of third party payor issues. Brown University Health employees are expected to...

About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors...

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes...

Position: Clinical Supervisor (RN) Clinical Case Manager Join a Company That Puts People First! Aveanna Healthcare is one of the largest private-duty nursing companies in the...

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...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...