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Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

A healthcare company seeks a Remote Utility Management Nurse to optimize insurance coding practices and enhance revenue management. This part-time role offers flexible hours and compensation ranging from $45 to $75 per hour, depending on...

Nightingale Nurses is seeking a travel nurse RN Case Management for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty: Case...

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. The role reports to the Manager of Utilization Management and helps...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

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...

Case Management Utilization RNPrimary Location: Harbor City, California Facility Name: South Bay Medical Center Employee Status: Regular Schedule: Part-time Scheduled Weekly Hours: 20 Shift: Day Salary: $68.95 - $84.38 / hour Job Number: 1434307...

RN Status Review Specialist It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Use your nursing expertise in a strategic, non-bedside role. As an RN Status Review Specialist, you'll evaluate patient...

Innovative Systems Group is seeking qualified healthcare professionals to conduct medical management and health education for customers on government programs. The role includes data gathering for regulatory reports and performing assessments,...

Registered Nurse (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

The McLaren system includes 12 hospitals across the state, ambulatory surgery centers, imaging centers, a 730-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 242,000 Michigan lives,...

Southern Illinois Healthcare is seeking a Registered Nurse or LPN licensed in Illinois to join our Population Health team in a fully remote capacity. The role emphasizes patient advocacy, care coordination, and coaching patients toward...

Explore opportunities with Amedisys, part of the Optum family of businesses. We provide home health, hospice and community-based services that help people receive quality care where they feel most comfortable: at home. Rooted in personalized care,...

*Job Summary and Responsibilities* As our Nurse Shift Manager, you will help lead and coordinate our exceptional nursing team so they can deliver timely, compassionate, and life-saving care to patients in critical situations. Every...

This range is provided by Mindlance. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $41.00/hr - $45.50/hr Direct message the job poster from...

Centene is seeking a Clinical Appeals Coordinator to act as the statewide liaison for appeals, ensuring NCQA and state compliance. Ideal for clinicians with case management experience who are detail-oriented and skilled in communication.

Sentara Health Plans seeks a Clinical Claims Reviewer RN for remote work. You will perform utilization management, review pre/post payment claims and authorizations for inpatient/outpatient cases, and address provider inquiries with appropriate...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Clinical Reviewer RN - Alabama Alabama, US 30+ days ago Requisition...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to...

VIVA USA Inc. is seeking a Quality Review Specialist for a fully remote role across the United States (excluding NY, CA, AK). You will collaborate with Utilization Management, Case Management and Customer Service to ensure appeals comply...

Elevance Health seeks a Telephonic Nurse Case Manager II for California, primarily remote with required in-person training. The role involves assessing, coordinating, and evaluating care plans for members with complex needs, telephonically.

HCSC is seeking a registered nurse or licensed clinician to provide care coordination to members via telephonic and field-based care management. You will educate members on health care programs, discuss goals, and support clinical operations with...

SCAN Health Plan Job OpportunityFounded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists...

Description RN- Registered Nurse - Case Manager Specialty: Case Manager Location: Los Angeles,CA,00000 Start Date: 2026-10-19 End...