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Cunningham Children's Home in Illinois seeks a Nurse Case Manager to support residential programs with medical case management, screening, education, counseling, and medication management. The role involves coordinating with community providers...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

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...

Job Details Field Nurse Case Manager (Remote) 2026-1480 Bethesda, Maryland, United States Medical Case Management Full Time Description Overview Are you looking to make a difference by...

Overview Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the...

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...

Sedgwick is hiring a Telephonic Case Manager (US Telecommuter) to support injured workers by planning medical care and advocating for timely returns to work. You will assess needs over the phone, coordinate services, and communicate with care...

WNS Healthhelp in the United States is seeking an RN/LVN Team Lead to oversee utilization management and case coordination. You will balance review work with leadership duties, monitor staffing, and ensure regulatory compliance across programs.

Humana is seeking a Telephonic Care Manager to support a remote case management program. You will coordinate care across sites and levels of care, leveraging resources to prevent readmissions and ensure integrated, compliant care plans for...

**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 for all product lines. Recommends and implements process...

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.

Medix is seeking a Remote Telephonic RN Case Manager to provide telephonic case management for chronically ill members within a C-SNP population. The role requires an active Compact State RN license or CA license and a strong commitment to patient...

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...

Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides...

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...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

Registered Nurse (RN) - PRN/Not Remote Rivendell Behavioral Health Servicesis an 80-bed full-service behavioral healthcare acute care facility located in Benton, AR, that has been providing quality health care to the residents of Arkansas...

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...

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...

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...

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...

Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00...

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...

Lead Care Coordinator The Lead Care Coordinator will provide hands-on expertise to other team members as needed to help ensure that every patient receives the right type of care, at the right time in the right setting, every day. The Lead...