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RN Case Manager Optum NY, is seeking an RN Case Manager to join our team anywhere within the U.S. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery...

Community Care Case Manager 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...

A company is looking for a Clinical Auditor Registered Nurse.Key ResponsibilitiesReview medical records and documentation for compliance with healthcare standards and regulationsConduct independent medical record and compliance reviews, providing...

Registered Nurse Care Manager Portland ME, Location. We have an exciting opportunity for an experienced Registered Nurse (RN) Care Manager to join our growing Population Health team! The RN Care Manager will work with patients whose...

Leading clinical operations across multiple states, the full-time Regional Clinical Services Director - RN will provide nursing leadership, consultation, and resources for patient care departments while ensuring compliance with diverse regulatory...

Bilingual Nurse Practitioner 100% Virtual, CareBridge Bilingual Nurse Practitioner 100% Virtual, CareBridge $5,000 Sign-on Bonus Seeking Bilingual Nurse Practitioner candidates that have an active, unrestricted Nurse...

Ohio RN Clinical Finance Specialist is a full-time remote position responsible for implementing clinical finance strategies, securing pre-authorizations, and managing clinical denials.Key ResponsibilitiesImplement and support clinical finance...

Director of Care Management 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...

A company is looking for an Associate Manager US Clinical Operations RN.Key ResponsibilitiesManage shift operations and ensure adherence to service level agreementsOversee team performance through coaching, performance reviews, and development...

LVN Charge Nurse (Licensed Vocational Nurse) LVN Charge Nurse (Licensed Vocational Nurse) is a licensed professional nurse directly under the supervision of the Director of Nursing Services. The LVN Charge Nurse (Licensed Vocational...

Seeking a remote California RN/LVN Utilization Management professional, the full-time nurse will review prior authorization requests for medical necessity across inpatient and outpatient services, applying CMS guidelines and Milliman Care...

Cedars-Sinai Guerin Children's At Cedars-Sinai, the work you perform daily has a direct effect on the lives of others. Our enthusiastic and committed culture has resulted in six Magnet designations for nursing excellence. The Smidt...

Supporting patient care remotely, the full-time Arizona Licensed RN Call Center will conduct assessments, provide emotional support, and connect patients with community resources while ensuring compliance with healthcare regulations.Key...

AltaMed Rn Case Manager If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed – it's nurtured, celebrated, and...

Overseeing hospice intake compliance, the full-time remote Hospice Clinical Compliance & Audit Associate Director will manage clinical audit activities to ensure documentation accuracy, regulatory compliance, and claim readiness while...

St. Francis Medical Center St. Francis Medical Center is here when you need us for life's most special moments. We deliver nearly 3,000 babies every year and we have a Level III NICU, ensuring that you and your family receive expert care...

Massachusetts RN Utilization Supervisor is a full-time remote position responsible for overseeing daily operations of Medicare Advantage utilization management staff, providing coaching and evaluation, and participating in organizational...

Leading a dedicated team in a full-time remote capacity, the Registered Nurse Manager, UM Operations will manage compliance and regulatory functions, oversee prior authorization processes, and implement strategies for the Utilization Management...

Supporting high- and rising-risk patients, the part-time Nightingale RN Care Coordinator will leverage clinical expertise for comprehensive care coordination and chronic disease management while working remotely between 8:00 AM and 4:30 PM.Key...

Leading the RN-led Complex Care Management program, the contract-to-hire RN Case Management Director will oversee strategy, clinical workflows, and operational performance in a remote setting, ensuring adherence to NCQA standards and driving...

Evaluating and managing catastrophic episodes of illness, the full-time remote South Carolina Licensed Stop Loss RN will facilitate cost estimates for underwriting, consult on claims, and provide case management oversight.Key...

Providing advanced clinical appeal services, the full-time Remote Clinical Financial Case Manager RN will manage complex patient account denials, conduct clinical reviews, and assist in developing denial prevention strategies while supporting the...

Providing advanced clinical appeal services, the full-time Ohio RN Clinical Case Manager will manage complex patient account denials, perform clinical reviews, and assist in the development of denial prevention strategies while working...