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Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

We are looking for a Travel Case Manager - RN RN for a great Travel nursing job in Los Angeles, CA. This Case Manager - RN Travel nursing job pays for 40 hours a week for 13 weeks. With Wanderly you can compare Travel nurse salary from leading Travel...

Centene Corporation is seeking a fully remote Utilization Management/Case Management nurse to perform concurrent reviews, discharge planning, and medical necessity assessments. The role requires 2+ years of acute care nursing and prior UM/CM...

OverviewStart your day from a home office!2-3 assessments per day! About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care...

This is a fully remote position, open to candidates based in United States. Pay: $60–$70/hr Role Title: Registered Nurse Role Type: Contractor Location: United States,...

Iconma Portal is seeking a Registered Nurse-Review Analyst for a remote position with a Health Insurance client. You will conduct prospective, concurrent, and retrospective reviews across inpatient, outpatient, ambulatory, and ancillary services...

Arkansas Blue Cross Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews for prior approvals, benefit inquiries, and inpatient/outpatient services. This role requires interpreting evidence-based criteria,...

American Health Plans Franklin, TN 37067, USA Description American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors...

Professional Development Specialist – Care Management At Cedars-Sinai, exceptional care begins with exceptional people. We are seeking a dynamic, collaborative Professional Development Specialist to advance the knowledge, skills, and...

Hines & Associates, Inc. seeks a Registered Nurse reviewer to assess patient conditions and certify treatments according to URAC and applicable regulations. The role emphasizes clinical judgment, documentation, and collaboration with case managers...

Medix is seeking a Remote Telephonic RN Case Manager to provide telephonic case management for chronically ill members within a C-SNP population. The role requires an active Compact State RN license or CA license and a strong commitment to patient...

Nurse Case Mgr II (RN) role at Elevance Health offers virtual, full-time care management for members with complex needs. The position emphasizes risk stratification, planning, implementation, and transition of care to optimize outcomes and access...

Harris Health is seeking a Referral Center Clinical Coordinator (RCCC) to drive coordinated care for high‑needs patients within our safety‑net system. The RCCC leads interdisciplinary care planning, facilitates case management, and advocates...

CorVel Corporation is seeking a Utilization Review Case Manager for a remote role. The ideal candidate holds an RN license and has 4+ years of clinical experience with utilization review, CPT/ICD coding knowledge, and strong communication skills.

CorVel is seeking a Utilization Review Case Manager to gather demographic and clinical data for in-patient and outpatient reviews, certify medical necessity, and assign appropriate LOS while supporting the Case Management department's goals. This...

Overview Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the...

JOB REQUIREMENTS: - Experience: 3 years acute care case manager experience - CA RN License - Certs: BLS - **FLU VACCINE (no exemptions)** Flu season starts September - Special Requirements: EPIC highly preferred. Due to nature of the role,...

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home...

Description RN- Registered Nurse - Case Manager Specialty: Case Manager Location: Los Angeles,CA,00000 Start Date: 2026-10-19 End...

Humana Healthy Horizons seeks a Behavioral Health Case Manager in South Carolina to assess enrollees' needs and coordinate clinical, community, and social resources for complex cases. This remote/field-based position requires travel, including to...

University Health is seeking a Utilization Management Nurse RN for UH Truman Medical Center in Missouri. The role manages resource use, supports care transitions, and advises care teams on documentation and discharge planning to improve patient...

Full-time Company Description WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare...

VIVA HEALTH in Birmingham, AL is seeking a Case Manager, Utilization Review to support members and high-risk patients. The role involves coordinating utilization review activities, performing timely medical records checks, and determining medical...

Sentara Health is seeking an Integrated Case Manager, RN. The role is remote but requires in-person face-to-face assessments. Travel to Roanoke and northern areas is required up to 60–90 minutes to see members about half to three-quarters...