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Centene is seeking a Clinical Review Nurse for a remote role supporting members in Pennsylvania. The candidate will perform concurrent reviews, assess care necessity, and contribute to discharge planning, leveraging case management or utilization...

Sentara Health Plans is seeking a Clinical Claims Reviewer/RN for a remote, full-time position. Responsibilities include utilization management, pre/post payment claim reviews, and authorization assessments across inpatient and outpatient cases,...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Compliance Nurse Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders,...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

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...

Details Client Name CSMN - 8714016 - Outpatient Ambulatory Care Job Type Travel Offering Nursing Profession Registered Nurse...

Registered Nurse - Case Management - Travel | Beverly Hills, California Estimated Weekly Pay: $2787.19 Start Date: 11/02/2026 | Duration: 13 Weeks Shift:...

Job Description Are 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...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the...

Fully remote (never coming onsite) Description: The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan...

City/State Fairfax, VA Work Shift First (Days) Overview: Sentara Health in Woodbridge, VA is looking to hire an Integrated Case Manager, RN. This is a remote position; however,...

Case Manager - RN / Clinical Liaison Hours: 9 am to 530pm Start date: ASAP Pay rate: $65,000 to $70,000 Position: Remote - Home Base Clinical Liaison / Case Manager Position: Work closely with...

Clinical Documentation Integrity Specialist Evaluates the day to day documentation practices of the Medical Staff and healthcare team on a complex patient population, and offers education and recommendations in accordance with the...

Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform-bringing health plan administration, holistic...

Lee Health is hiring for a Utilization Management RN position. This remote role begins onsite for the first 90 days and requires licensure in Florida. The nurse will perform utilization management duties, ensure regulatory compliance, and document...

Travel RN-Case Manager RN-Case Manager travel nurse jobs at the facility in Arkansas let you coordinate patient-centered care across acute and rehabilitation settings, focusing on safe transitions and optimal outcomes. You will use your...

Inpatient Case Manager The Inpatient Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified patients during an acute care episode. Assesses and develops a...

UW Hospital and Clinics seeks a Nurse Case Manager (RN) to join our multidisciplinary team; remote work options available with flexible shifts. The role emphasizes utilization management, patient status assessment and collaboration with care teams...

Telephonic Nurse Case Manager I Telephonic Nurse Case Manager I Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and...

Case Manager RN The University of Miami UHealth Department of UMHC-SCCC Business Operations has an exciting opportunity for a full time Case Manager RN. The incumbent coordinates the overall interdisciplinary plan of care for patients,...

Nurse Case Manager II Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work. The...

Centene Corporation is seeking an experienced appeals liaison to work remotely within the Eastern and Central time zones. The role focuses on review of clinical information to determine medical necessity and preparing compliant appeal letters.

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

Responsible for collaborating with healthcare providers and physicians for problem solving, prioritizing and facilitating patient care objectives, the coordination and...