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Company Overview At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our...

PIH Health in Los Angeles is seeking an RN Peer Review Analyst responsible for retrospective medical record reviews, data compilation to validate quality and accuracy of documentation, and auditing charts for admission/continued stay. You will...

Centene Corporation in Wisconsin is seeking an Appeals Liaison to coordinate statewide appeals, fair hearings, and external reviews. You will ensure letters meet State and NCQA requirements and work with Medical Directors to clarify medical...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing...

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...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty:...

Job Title 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 member needs and...

Guidehealth in the United States seeks an experienced RN Case Manager to work remotely with Illinois licensure. You will oversee member management, promote wellness, and support cost-effective care within a value-based care framework.

Sentara Health in Richmond, VA is seeking an Integrated Case Manager, RN on a full-time basis. This role combines remote work with required in-person assessments and regional travel to partner sites. The nurse will oversee care plans,...

UnitedHealth Group is seeking a Clinical Grievances Nurse to review retrospective cases for appropriate care and address members' immediate needs. The role embraces remote PST hours with an on-site base in Mesa, AZ, requiring CA residency and an...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

Molina Healthcare is seeking a licensed RN Case Manager in Texas to support women's health and LTSS coordination from a home-based setting. You will evaluate member needs and lead care coordination for high-risk pregnancies, using the Molina...

WNS Healthhelp in the United States is seeking an RN/LVN Team Lead to oversee utilization management and case coordination. You will balance review work with leadership duties, monitor staffing, and ensure regulatory compliance across programs.

Responsible for evaluating and expediting cost-effective medical treatment for injured employees, the full-time remote Georgia Licensed Telephonic Nurse Case Manager will manage disability cases, coordinate early return to work efforts, and...

Humana Inc. is seeking a remote Telephonic Care Manager reporting to a Manager of Care Management to deliver comprehensive case management across the continuum of care. You will coordinate with DoD contract requirements and leverage...

Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

Brighton Health Plan Solutions is seeking an experienced Utilization Management Nurse to perform medical necessity and benefit reviews remotely, supporting both inpatient and outpatient cases. The role requires an active LPN license, strong...

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and...

Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...

RN CASE MANAGER – CARE MANAGEMENT DEPARTMENT - University of New Mexico Hospital – Albuquerque *Inpatient *Outpatient *Utilization Management *SRMC Care Management *Full Time *Part Time Receive 17% Weekday Nights, 26% Weekend Nights and 15%...

Behavioral Health Manager, Nurse Practitioner-Integrated Care Delivery (NP-ICD) Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That...

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...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity. You will perform concurrent reviews and engage with physicians...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse for remote concurrent review responsibilities. The role assesses member health status, medical necessity, and appropriate care levels, contributing to discharge planning within...