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Professional Development Specialist – Care Management At Cedars-Sinai, exceptional care begins with exceptional people. We are seeking a dynamic, collaborative Professional Development Specialist to advance the knowledge, skills, and...

CVS Health Corporation in the United States is seeking a Utilization Management Nurse Consultant to coordinate, document, and communicate all aspects of the utilization/benefit management program. This 100% remote role requires applying clinical...

Cunningham Children0s Home in Urbana, IL seeks a Nurse Case Manager to support residential programs with medical case management, screening, education, counseling, and medication management, while networking with community health providers. The...

Health Care Service Corporation (HCSC) is seeking a QOC Nurse to join our team under the supervision of the QOC Manager. You will conduct reviews and investigations of potential quality of care issues in a timely and efficient manner, supporting...

Sentara Health is seeking a Remote Integrated Case Manager who will conduct telephonic and in-person assessments, develop and oversee comprehensive care plans, and coordinate authorizations within the benefits structure. The role requires an RN...

Optum NY seeks an RN Case Manager to coordinate referrals for high‑risk members, educate patients on illnesses and treatments, and support care plans across the continuum. The role emphasizes strong clinical expertise and collaboration with...

Job Summary: Collaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental...

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...

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...

Telephonic Insurance Case Manager (RN) | ARIZONA RESIDENTS ONLY Insight Global is seeking a Telephonic Insurance Case Manager (RN) to join a growing and well-established organization focused on helping injured employees navigate their...

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Company : Highmark Inc. Job Description :JOB SUMMARY This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction...

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...

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...

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...

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...

Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges.

Job Description Professional Development Specialist - Care Management Cedars-Sinai | Integrated Care Management (ICM) & Integrated Service Planning (ISP) Empower People.

UnitedHealthcare in Fayetteville, NC is seeking a Care Manager Registered Nurse to assess, plan and implement individualized care interventions while advocating for the best possible care. The role offers a remote work option and a four 10-hour...

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...

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...

RN CASE MANAGER – CARE MANAGEMENT DEPARTMENT - University of New Mexico Hospital – Albuquerque *Inpatient *Outpatient *Utilization Management *SRMC Care Management *Full Time *Part Time Receive 17% Weekday Nights, 26% Weekend Nights and 15%...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations. You will report to the Manager of Utilization Management and serve...