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Clinical Nurse Professional Development Educator Advanced How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At...

UnitedHealth Group is seeking a Telephonic RN Case Manager to act as the primary contact for members with complex medical and social needs. You will conduct telephonic assessments, create person‑centered care plans, and coordinate services...

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...

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,...

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...

Spectrumforce Technologies, Inc. is seeking a Care Manager (RN) to support Medicaid members remotely in Florida. The role involves reviewing referrals, proactive outreach, and guiding members through care management, education, and coordinated...

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care...

Sentara Health is seeking an Integrated Case Manager, RN to support Eastern Shore region members, concentrating on behavioral health, waiver services, and complex care management. This remote role requires Virginia residency with travel 50%–75%...

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...

Find your calling at Mercy! The Nurse Navigator is a leader providing support, mentorship, and guidance to those who provide direct patient care. The Nurse Navigator coordinates the delivery of patient care by...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

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...

Akima Global Logistics (AGL) seeks an experienced registered nurse to join a multidisciplinary team and drive medical clearance for ATC candidates. You will assess applicants, schedule drug screens, and update records while applying deep medical...

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 service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities...

Job Title: Remote Prior Authorization Registered NurseJob Description We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid) populations. In...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

Improve the lives of others while Caring. Connecting. Growing together. Job Description - HSS Clinical Coordinator RN - Telecommute in Texas (2391171) HSS Clinical Coordinator RN - Telecommute in Texas - 2391171 At...

Renown Health is seeking a Utilization Management RN to apply medical necessity criteria for prospective and concurrent reviews. You will work with an interdisciplinary team to ensure medically necessary, cost-effective care at the appropriate...

Description: Job Summary: Responsible for the oversight and management of skilled patients and temporary skilled patients in rehabilitation in contracted Skilled Nursing facilities; this includes checking benefits, managing up...

CVS Health is seeking a licensed RN to join American Health Holding, Inc (AHH) as a remote Case Manager. This telephonic role serves across multiple states for fully and self-insured clients, with virtual training and ongoing support. The...

Integra Partners seeks an experienced Utilization Management Nurse Supervisor to lead the UM nursing team, ensuring performance, accountability, and professional development. You will conduct regular 1:1s, manage performance reviews, and drive...

Full-Time Case Manager(LPN/LVN) Are You Ready to lead in Healthcare? We are currently seeking a Full-Time Case Manager(LPN/LVN) to join our outstanding healthcare team! Salary Range: $83,200.00 per year We are passionate...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...