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To ensure timely and accurate care decisions, the full-time Utilization Review Nurse LVN/LPN will perform clinical reviews for medical necessity and benefit coverage, applying clinical guidelines and maintaining compliance in a remote work...

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...

Kaiser Permanente in Los Angeles seeks an experienced Registered Nurse to coordinate admissions, screen for medical necessity, and develop safe discharge plans with the MD and multidisciplinary team. You will advocate for patients,...

Vocational Nurse Opportunity Beyond outstanding employee benefits including health and dental insurance, vacation, and a 403(b), we take pride in hiring the best employees. Our accomplished staff reflects the culturally and ethnically...

Sentara Health in Williamsburg, VA is seeking a qualified Quality Assurance Coordinator to join our Home Care team on a full-time, day shift. This remote position emphasizes ensuring that Home Care products and services meet quality standards and...

UnitedHealthcare in Fayetteville, NC is seeking a Care Manager Registered Nurse to assess, plan and implement individualized care interventions while advocating for the best possible care. The role offers a remote work option and a four 10-hour...

Humana Inc. seeks a Telephonic Nurse Care Manager to support patients transitioning between services. This full-time, remote role involves determining level of care, guiding patients through home health, hospice and palliative options, and...

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Molina Healthcare is hiring a remote RN Care Manager with a preference for candidates in Washington State. The role operates on Pacific Standard Time hours and focuses on telephonic case management for Medicare members, with no travel, direct...

Working remotely in a full-time capacity, the Florida RN Utilization Reviewer will conduct admission, concurrent, and retrospective reviews of medical records to ensure compliance with clinical performance standards and reimbursement guidelines...

CVS Health is hiring a Remote Case Manager RN to support the Costco Team from home. You will assess member needs, develop care plans, coordinate resources, and collaborate with multidisciplinary teams to improve health outcomes. This role...

Case Management Specialist RN (Bilingual)Works collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify...

Job Description Why work here? Beyond outstanding employee benefits including health and dental insurance, vacation, and a 403(b), we take pride in hiring the best employees. Our accomplished staff...

Sentara Health Plans is seeking a Care Coordinator- LPN to provide case management for Members in Nursing Facilities across Roanoke, Lynchburg and Danville areas. The role is remote from home with periodic travel to facilities; typical hours are...

UnitedHealth Group is hiring for a Dallas-area role that supports care coordination and member advocacy in a dynamic community health setting. The position emphasizes person-centered planning, resource connection, and cross-disciplinary...

Humana Inc. is seeking a RN Field Care Manager 2 (Physical Health) in Louisiana to assess needs, guide members to resources, and coordinate care with providers. This role is field-based with a remote home office when not visiting members.

Responsible for independently utilizing the nursing process to safely, therapeutically and efficiently care for a group of patients based on policies and procedures.

Molina Healthcare of California is seeking a Transition of Care Coach LVN/LPN. This remote role requires an active California LVN/LPN license. Typical hours are Monday–Friday, 8am–5pm Pacific Time, with 40–50% local travel as needed.

To support care management functions, the full-time Health Services Intake Specialist will facilitate eligibility and benefit verification, authorization status inquiries, and documentation processes, initially training onsite before becoming...

CVS Health is seeking a QM Nurse Consultant to apply specialized clinical knowledge and drive quality improvement across patient care. The role emphasizes data analysis, regulatory compliance, and developing quality assurance programs, with a...

Case Management Specialist RN- Per DiemWorks collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify...

UnitedHealth Group is seeking a Hospital Safe Discharge Case Manager to proactively coordinate discharge planning across acute care settings. You will work with facility CM/UM staff, medical directors, and care teams to resolve barriers and ensure...

Job Description Why work here? Beyond outstanding employee benefits including...

Humana Inc. is seeking a part-time Care Manager, Telephonic Nurse, to support patients transitioning into and out of CenterWell Home Health services. This remote, telephonic role requires a compact RN license, an associate degree (BSN...

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