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Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...

Job Description: The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing...

Job Summary and ResponsibilitiesAs our Professional Development Program Coordinator collaborates with the Nursing Directors, facility, market and Division leaders, and CommonSpirit Health National Nurse Residency Program Leadership to provide...

Job Title This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 hr shift Considering local candidates only!!! Why Choose Saint Joseph Health System? At Saint Joseph Health...

Thank you for considering a career at Bon Secours! Scheduled Weekly Hours: 40 Work Shift: Days (United States of America) Summary of Primary Function In the capacity of a Registered...

Clinical expertise meets analytical precision in a role that directly shapes how patient care is captured, understood, and valued across the health system. As a Clinical Documentation Specialist, you bring a seasoned nursing perspective into a...

Harris Health seeks a Nurse Manager to lead the operational management and care delivery for one or more clinics or units. This role oversees human resources, quality, and financial performance within the assigned area.You will work with the...

Denials Case Manager, RN The Denials Case Manager, RN appeals all denials using InterQual criteria and medical necessity. Collaboratively works with all members of the revenue cycle team and all types of payers to resolve denials,...

Description Telephonic Nurse Case Manager (1099 Remote - NJ RN License Required) We are currently seeking an experienced Telephonic Nurse Case Manager (RN) to support workers'...

Direct Jobs is seeking a Nurse Manager for the Emergency Service Administration in Houston, Texas. The Nurse Manager will be responsible for operational management and the delivery of quality patient care across the clinic. With oversight of...

Job Details Telephonic Triage Nurse Case Manager (Remote) 2026-1475 Dallas, TX, USA Medical Case Management Full Time Description Overview Are you looking to make a difference by providing...

Join Our Caring Community As a RN Care Manager, you will enjoy a true work-life balance with no night or weekend shifts. Reporting to the Manager of Care Coaching, you will support members enrolled in the Wisconsin Family Care Program...

Job Summary and Responsibilities As our UM RN (Utilization Management Registered Nurse), you will be responsible for ensuring the integrity of the adverse determination processes and accuracy of clinical decision-making, as...

College Nurse This is a continuous recruitment to fill part-time, temporary, hourly assignments on an as-needed basis. Departments or divisions will refer to the pool of applicants on file to fill temporary assignments as needed. You will...

Utilization Management Nurse RIHS Austin Regional Office - Austin, TX 78727 Overview Position Type Full Time Description Primary Responsibilities The Utilization Management Nurse will determine the...

About Abby Care: Powering the Future of Care at Home for All of America Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever.

Manager, Telephonic Nurse Case Management The Nurse Case Manager serves as the clinical resource within the Risk Management & Safety team, providing telephonic nurse case management to support injured employees through the workers'...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

Job Opportunity Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the...

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

At Caregenix, we are committed to delivering exceptional, value-based care. Our team lives by the iCARE values-Integrity, Compassion, Accountability, Respect, and Excellence-in everything we do. If you are passionate about improving patient...

Job Summary: Responsible for the oversight and management of skilled patients and temporary skilled patients in rehabilitation in contracted Skilled Nursing facilities; this includes checking benefits, managing up to discharge...

Overview: RN / Registered Nurse, Home Health ...

Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS).

" The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal...