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UnitedHealthcare is seeking a Maternal Registered Nurse Case Manager to coordinate care for Medicaid members who are pregnant or recently pregnant, including home and social assessments and education. This role supports medical, behavioral, and...

PriMedical, Inc. is seeking a Field Case Manager to ensure injured workers receive the care they need and return to work safely. This home-based position coordinates with providers, monitors progress, and develops individualized care plans...

Job Summary Responsible for the oversight and management of skilled patients and temporary skilled patients in rehabilitation in contracted Skilled Nursing facilities; this includes checking benefits, managing up to discharge and issuing denial...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Employment Type: Full time Shift: Night Shift Description: Position Summary: Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

Wellmark, Inc. is seeking a Case Management Nurse I to support members with chronic and complex health needs. You will develop individualized care plans, coordinate with providers and resources, and guide members through care pathways in a...

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...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and...

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...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

Oscar Health is hiring a Case Manager to join our Complex Case Management team. You will collaborate with Oscar teams to deliver high-quality care and improve member health outcomes, educating members, evaluating SDOH, and connecting individuals...

Benefits: 401(k) 401(k) matching Bonus based on performance Company parties Dental insurance Employee discounts Free food & snacks Health insurance Opportunity for advancement Paid time...

nirvanaHealth, a RxAdvance Corp. company, seeks a part-time Utilization Management Nurse for a remote role in the United States. You will perform prospective, concurrent, and retrospective medical necessity reviews and care coordination to ensure...

Overview CORE Health Networks, the recognized leader in Integrated Occupational Medicine Services, provides integrated solutions to your occupational healthcare needs. We are currently seeking a full-time Case Manager (Registered Nurse)...

Humana Inc. is seeking a Telephonic Behavioral Health Nurse Care Manager based in Oklahoma. The role focuses on assessing enrollees, guiding families to appropriate resources, and coordinating with an interdisciplinary team to ensure holistic,...

Hospitals on Incredible Health are actively hiring and accepting applications in the Los Angeles, CA area for the following position: Registered Nurse - Case Management Supervisor. Nurses with experience in any of the following areas are strongly...

Select how often (in days) to receive an alert: Date: Sep 21, 2026 Location: Any city, KS, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of...

Job OpportunityAre you ready to bring your clinical competencies to a world-class Medical Group known for the very highest clinical standards? Do you have a passion for the highest quality and patient satisfaction? Then please respond to this...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

PIH Health Downey Hospital is seeking an RN Case Manager to oversee a continuum of care from pre-admission through post-discharge, ensuring efficient progression for assigned patients.Focus on appropriate utilization of hospital services,...

Job title Senior Care Specialist (Registered Nurse) – Work From Home About Sagility Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to...

Job Description: The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing...

Genex Service LLC in El Monte, CA hires a Medical Field Case Manager to coordinate in-person patient appointments, collaborate with treating physicians and employers, and develop treatment plans aimed at quick, safe return-to-work. The role...