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Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...

Case Manager RN Opportunity This outstanding unit is looking for the right Case Manager RN to join their team of compassionate and driven health care professionals. Join this highly motivated team of caregivers and enjoy a challenging and...

Molina Healthcare is seeking an RN Case Manager to join our team and support Medicare members across the Illinois service area. This telephonic role may require occasional face‑to‑face meetings and occasional local travel. The candidate...

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%...

Centene Corp. is seeking a remote RN Care Manager to develop and coordinate comprehensive care plans for members, ensuring high-quality, cost-effective outcomes. You will assess needs, facilitate access to services, educate families, and...

Clinical Grievances Nurse 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...

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.

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...

Clinical Eligibility & Intake Nurse Part Time/1099 Contractor Fully Remote Monday-Friday; 3-5 hours per day / 15-20 hours per week*; schedule must overlap intake hours** Clinical Operations Reporting 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,...

Optum Home & Community Care, part of UnitedHealth Group, is hiring a Telephone Case Manager RN for remote work. The role supports a diverse member population with education, advocacy and connections to resources to stay well at home. The...

Sedgwick is hiring a Telephonic Case Manager (US Telecommuter) to support injured workers by planning medical care and advocating for timely returns to work. You will assess needs over the phone, coordinate services, and communicate with care...

Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including...

Humana is seeking a Telephonic Care Manager to support a remote case management program. You will coordinate care across sites and levels of care, leveraging resources to prevent readmissions and ensure integrated, compliant care plans for...

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...

Care Manager 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...

Care Critical Nursing Role Achieved Date (No Value) Expiration Date (No Value) License # (No Value) Achieved Date (No Value) Expiration Date (No Value) Additional Job Details: (No Value) Role Type: Care Critical - KFH Clinical or Non...

Full-Time Hospice Intake & Admissions RN Are you an RN who values meaningful connections and wants to make a difference at one of life's most important moments? Join The Community Hospice as part of our Central Intake & Admissions Team,...

Admissions Nurse Location: USC Arcadia Hospital Schedule: Tuesday - Saturday, 12pm - 8:30pm Salary Range: $50 - $55 / Hourly Why Hospice? Why VITAS? Have you ever considered hospice as a...

Workers' Compensation Care Coordinator Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors and...

CareHarmony's Care Coordinators (LPN) (NLC) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced Licensed Practical Nurse - LPN Nurse (LPN)...

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...

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.

Registered Nurse – Case Manager – Travel Location: Torrance, CA If you are a qualified Registered Nurse and looking for an exciting contract position with competitive compensation and benefits packages, apply today! Job...

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...