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HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate discharge planning within Medicare, AHCCCS, Self-pay, and other payer guidelines. The...

Mercor connects elite creative and technical talent with leading AI research labs. A remote Utilisation Management leader role is available, requiring RN licensure and physician-advisor experience. Contract position with high-level...

Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong...

Our Story Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America, we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier...

Randstad USA is seeking a hybrid RN Case Manager in the greater Arlington, VA area. This role blends home-based and field work, covering Falls Church, Annandale, Springfield, Arlington, Alexandria; mileage reimbursed. The ideal candidate...

UnitedHealthcare is hiring a Field Based HSS Clinical Coordinator RN in Duval County, TX to assess, plan, and coordinate care while connecting members to resources and providers. This role offers remote work within the assigned territory and...

Elevance Health in Florida is seeking a Medical Management Nurse to review complex cases, apply nursing judgment, and determine medical necessity for services. This role combines remote work with required in-person training sessions and periodic...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

ATC Candidate Medical Clearance Coordinator Serves as a member of a multidisciplinary team to provide assessment, planning, implementation, coordination, evaluation and monitoring of ATC Candidates throughout the medical clearance...

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...

Nurse Case Manager - Fully Remote Join Insurance Program Managers Group (IPMG) and become part of a dynamic team committed to innovation in insurance! For the past 25 years, our mission has been to create one-of-a-kind insurance solutions...

Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical...

Case Management Nurse The Case Management Nurse delivers comprehensive, client-centered case management services across the continuum of care, ensuring that each individual receives the most appropriate level and type of health, medical,...

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

UnitedHealth Group is seeking a dedicated RN Case Manager - HouseCalls in Columbia, MD. You will perform telephonic outreach, help coordinate appointments, and connect patients with social work and clinical resources while documenting all...

Guidehealth is seeking a remote-based Care Manager (RN) to guide patients and families through complex health journeys. You will blend clinical expertise with holistic care, addressing medical, behavioral, and social needs while coordinating...

Field Case Manager Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an...

Care Management Coordinator/RNLocation: 100% Remote Duration: 3+ Months (FT conversion)This is a Utilization Management RN part time position - working every other weekend (2 days a week in a 2 week cycle). Must be available M-F 8:30-4:30pm for...

Nurse Case Manager The Nurse Case Manager (NCM) is responsible for applying medical knowledge in reviewing workers' compensation claims to assess, evaluate, plan, implement and oversee the treatment appropriateness for occupational...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

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...

Case Manager - RN / Clinical Liaison Hours: 9 am to 530pm Start date: ASAP Pay rate: $65,000 to $70,000 Position: Remote - Home Base Clinical Liaison / Case Manager Position: Work closely with...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

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...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the...