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Registered Nurse (RN) For Utilization Management Team We are seeking a Registered Nurse (RN) to join our Utilization Management team. In this role, you will perform concurrent reviews, prior authorizations, medical necessity reviews,...

Included Health is seeking a Telephonic Maternity Nurse Care Manager to support members through pregnancy and postpartum with evidence-based, holistic care. You will guide through routine and high-risk experiences, coordinating with a...

Integra Partners seeks an experienced Utilization Management Nurse Supervisor to lead the UM nursing team, ensuring performance, accountability, and professional development. You will conduct regular 1:1s, manage performance reviews, and drive...

Details Client Name Dignity Health California Hospital Medical Center Job Type Travel Offering Nursing Profession Nursing...

Provide essential clinical and administrative support to a remote healthcare team across Canada. Manage laboratory results, pharmacy communications, referrals, and patient follow-ups. Requirements: Current...

Yoh, a Day & Zimmermann company, is seeking an Utilization Management Nurse Coordinator (RN) for a remote contract opportunity based in Fairfield/Redding, CA. Training is onsite for 3 weeks, then remote with regular weekday hours and one weekend...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

University Hospitals is seeking a Registered Nurse to collaborate with the health care team to coordinate admissions, continued stays, and level-of-care decisions. You will communicate with patients and families to ensure timely care and proper...

Field Nurse Case Manager - Glendale, CA Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose. Every...

Emanate Health in Covina, CA, seeks a Utilization Review Nurse to evaluate medical records and determine medical necessity using policies and guidelines for urgent and standard reviews. You will document decisions and support claims reviews,...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Pay Package: Total weekly gross $ 2979 for 40 hrs Job Description: Tittle: RN Case Manager Location: Mission Hills, CA 91345 Duration: 13 weeks Guaranteed hours: 40 hrs Shifts: Day Job Description: Start Date:...

*Description* *Advanced Specialty Staff RN - Outpatient Behavioral Health at Providence Little Company of Mary Medical Center San Pedro in San Pedro, CA. This position is Per Diemand will work 12-hour,...

Your Role The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Chronic Care Coordinator Location: MICHIGAN - 100% REMOTE (NOT A COMPACT STATE) Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing problems before...

Lead complex care management for members with primarily physical health needs through comprehensive assessments, person-centered care planning, coordination, education, and ongoing monitoring. Support PHCO Case Management and collaborate with...

At UK King's Daughters, we're not just a healthcare facility - we're a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We're more than just a place to work; we're a place to...

Lee Health is hiring for a Utilization Management RN position. This remote role begins onsite for the first 90 days and requires licensure in Florida. The nurse will perform utilization management duties, ensure regulatory compliance, and document...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

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...

Benefits: 401(k) Competitive salary Dental insurance Health insurance Paid time off Signing bonus Training & development Vision insurance Outpatient Case Management West Los Angeles VAMC 11301...

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare- Complex Spine Team) We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At...

Care Management Team Member The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Opco-Skilled-Management- is seeking a Central Intake Nurse to coordinate initial and ongoing referral documentation from physicians, insurers, and providers to determine service appropriateness and facility placement. You will develop patient care...