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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...

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...

Fully remote (never coming onsite) Description: The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan...

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.

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...

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...

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...

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...

Guidehealth, a data-powered healthcare company, is seeking a licensed RN Case Manager to work remotely from Wisconsin. You will collaborate with clients and members to promote wellness, navigate the health system, and manage case assignments from...

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...

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...

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...

Optum is seeking an experienced Telephone Case Manager RN to support a diverse member population with education, advocacy, and connections to necessary resources. This remote role operates Monday through Friday, 8 AM–8 PM, nationwide across the...

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...

Admissions Nurse Location: USC Arcadia Hospital Schedule: Tuesday - Saturday, 12pm - 8:30pm Salary Range: $50 - $55 / Hourly Why Hospice? Why VITAS? Have you ever considered hospice as a...

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...

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...

UnitedHealth Group's Optum Care at Home is seeking a Telephonic RN Case Manager to serve as primary contact for members with complex medical, behavioral health, functional, and social needs, coordinating care across Medicaid LTSS, home health, and...

A reputable healthcare staffing firm in Oregon is seeking a care manager specializing in phone communication with patients across all ages. The role involves coordinating care services, educating patients on their health conditions, and conducting...

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...

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,...

Sentara Health Plans is hiring a Clinical Claims Reviewer RN for a remote role. The position is full-time, 40 hours, with standard hours 8am–5pm EST, Monday to Friday. Remote opportunities are available across many states, including New...

Brighton Health Plan Solutions, LLC is seeking an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely in North Carolina. You will use evidence-based guidelines and internal criteria to determine...

Sedgwick is seeking a Telephonic Case Manager (RN) for a fully remote role in the United States. You will partner with injured workers, employers, and medical providers to develop case management strategies aimed at medical recovery and successful...

Nurse Care Manager The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while...