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Santa Barbara Cottage Hospital is seeking an experienced RN/LPN to perform remote clinical reviews for appeal cases. You will review medical records, apply InterQual criteria, and prepare clinical determinations for physician review. The...

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

Humana is seeking a remote Telephonic Care Manager to lead a comprehensive case management program, coordinating care across sites and providers to reduce readmissions and optimize resource use. You will serve as the primary contact for...

Forthright Case Management Llc is seeking a self-motivated Registered Nurse (RN) for a per diem, hybrid role based in Albuquerque, NM. You will coordinate medical care for injured employees and collaborate with the treatment team, insurers, and...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health,...

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...

A healthcare company is hiring a Nurse Liaison to coordinate care and relevant medical information for injured workers. This remote, field-based role involves engaging with clients, maintaining communication with various stakeholders, and ensuring...

A healthcare organization is seeking a remote RN to manage patient care related to chronic kidney disease. Responsibilities include ensuring continuity of care, coordinating treatment plans, and documenting patient information. Candidates must...

COPE Health Solutions is seeking a qualified Utilization Management Nurse (RN) to assess member needs, determine medical necessity and coordinate care across providers and care teams. This full-time, remote position reports to Medical Management...

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...

NurseRemotely is seeking a registered nurse for a remote, field-based case management role. The position coordinates care among the Injured Worker, the Insured, and the Carrier to facilitate treatment and return to work, with regional travel up to...

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...

aptihealth is seeking a Registered Nurse Case Manager to support both patients and providers across the care continuum. In this key role, you will assess patient needs and coordinate care while ensuring compliance with regulatory requirements.

CVS Health is seeking a Registered Nurse for a full-time remote telehealth role focused on case management for vulnerable members facing complex medical, behavioral, and social challenges. You will assess, plan, implement, and coordinate care to...

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,...

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...

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...

A healthcare solutions company is seeking a remote Case Management Nurse to lead a multidisciplinary team providing holistic care. The role requires a compact RN license and offers a pay range of $37.00/hr - $39.00/hr. Candidates should have 3...

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,...

PIH Health Downey Hospital is seeking an RN Case Manager to guide patients from pre-admission through post-discharge, ensuring smooth transitions and appropriate utilization of hospital services.You will focus on maximizing reimbursement from...

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...

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...

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...

Job Title: Clinical Operations Manager - Virtual Care Management (RN) Location: Remote - United States Employment Type: FT Exempt Direct Reports:...

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...