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Guidehealth is seeking a remote RN Case Manager with an Illinois nursing license to enhance member management, satisfaction, and cost effectiveness. You will support wellness, coordinate care, and navigate the healthcare system as part of the...

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,...

Alliance Health is seeking an UM Clinical Specialist RN for Physical Health who works remote with NC-based residency and occasional travel for in-person meetings. The role focuses on medical necessity reviews for inpatient and outpatient services,...

## Centralized Triage Registered Nurse (RN) - RemoteApplyremote type: Remotelocations: Birmingham, ALtime type: Full timeposted on: Posted Yesterdayjob requisition id: R-101012**Job Description:****About Us:**Affinity Hospice is one of the fastest...

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the...

Broadway Ventures, a veteran-owned SDVOSB headquartered in Mississippi, seeks an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud referrals. You will apply clinical expertise...

Qualifications VA Health Professional Trainees (HPT) pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. A HPT is an individual...

Sinai Hospital's Utilization Review operates as a distinct specialty service line of physician advisors, nurses, and support staff who ensure hospital stays are clinically appropriate and fully covered by the patient's insurance. The team focuses...

3:15 is looking for a qualified Registered Nurse (RN) to manage the care of patients through various continuous care programs including Remote Patient Monitoring. The RN will welcome patients, educate them on health device usage, and create...

A healthcare company is seeking a compassionate and detail-oriented RN Triage Nurse for a remote role based in Charlotte, NC. Ideal candidates will have at least 5 years of experience in nursing, particularly in emergency departments or call...

To enhance the capabilities of clinical audit staff, the remote Clinical RN Training Specialist will design, develop, and deliver specialized training programs focused on Inpatient Psychiatric Facility (IPF) and Inpatient Rehabilitation Facility...

Join to apply for the Nurse Advocate - Remote- Kansas role at Synergy Healthcare USA, LLC We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate for our new client and their employees.

A healthcare staffing agency in Guilford County, NC, is seeking a ClinicalLTSS Care Manager. This mid-senior level contract role involves developing and coordinating holistic care management activities for healthcare members with long-term support...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plan is currently hiring a Medical Policy Research Specialist/ Registered Nurse (RN) - Remote in Virginia! ...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

Origin Travel Nurses is seeking a Case Manager responsible for utilization review and case management in a hospital setting. You will perform chart reviews, quality assessments, and ensure appropriate discharges while adhering to InterQual SI/IS...

Job TitleWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity...

Medcor is seeking a full-time Registered Nurse for its remote 24/7 Occupational Health triage call center. Shifts run 3pm–4am CST, typical days include 8-hour or 10-hour windows, with 40 hours per week and occasional weekend/holiday rotation.

A leading healthcare company is seeking a Tele-Health Nurse to provide high-quality service for specialty prescription drugs. This role includes case management and patient coordination. Ideal candidates should possess a Vocational or technical...

A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The...

The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace...

University of California - Los Angeles Health seeks a Senior Case Manager to coordinate care for international patients. You will review referrals, arrange MD-to-MD case reviews with physicians abroad, and educate patients and families about the...

Nurse Case ManagerUnder the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, acting as a resource to staff and physicians in resource efficiencies and...

SCAN Group is seeking a remote RN to enhance frail seniors' ability to age in place by delivering person-centered care via telephonic care coordination. You will develop and implement plans of care, educate members, and coach them to manage...