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Elevance Health in Florida is seeking a Medical Management Nurse to review complex cases, apply nursing judgment, and determine medical necessity for services. This role combines remote work with required in-person training sessions and periodic...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

National Care Advisors is seeking a Nurse Case Manager based in the Seattle/Tacoma area to coordinate case management for eldercare and special needs clients. You will collaborate with family caregivers, attorneys, financial planners, and trustees...

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...

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is...

Company Details Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is...

Virginia Mason Medical Center in the Puget Sound region seeks a Clinical Documentation Review Specialist (RN) to clarify patient records for appropriate reimbursement and care complexity. You will conduct concurrent reviews and engage with...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Part Time Southborough, MA, US Salary Range: $38.00 To $40.00...

*This role will require the successful candidate to work the shift of Monday to Friday, 1pm to 10pm Central (2pm to 11pm Eastern). The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This...

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Downey, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment...

Details Client Name Dignity Health California Hospital Medical Center Job Type Travel Offering Nursing Profession Nursing...

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...

McLendon Leadershi in Glendale, CA is seeking a Case Manager Nurse to coordinate patient care across hospital and home health settings, optimize utilization, and support smooth transitions for patients. The ideal candidate will bring expertise in...

RN Care Manager *F/T Variable* Santa Monica, California Full Time RN Care Manager with our Care Management Team at our Cedars-Sinai Tarzana Medical Center in Tarzana, CA. This is a full-time...

Telephonic Nurse Case Manager Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is...

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...

CVS Health is seeking a Nurse Consultant for a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient and outpatient services, authorize care, and escalate cases as needed, while coordinating with...

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...

Managed Medical Review Organization is seeking an RN to join the team in a remote, home-office role. The position emphasizes telephonic/customer service skills, meticulous documentation, and solid clinical experience, with no face-to-face patient...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

Elevance Health (Anthem) is seeking a Med Mgmt Nurse to support members remotely with periodic in-person training sessions. The role emphasizes nursing judgment to assess medical necessity, collaborate with providers, and optimize member outcomes.

Back RN/Managed Care Coordinator - Remote Healthcare Columbia , South Carolina Contract Hybrid Oct 9, 2026 RN/Managed Care Coordinator - Remote Job at a Glance Title:RN/Managed Care...

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...

Revive Therapeutic Services seeks a Nurse Case Manager to oversee patient care plans and coordinate services for individuals facing health challenges. You will collaborate with patients, families, and providers to ensure effective care delivery.