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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 good for people...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote capacity. The role reviews inpatient and outpatient services using evidence-based criteria, authorizes care with providers, and escalates cases as needed.

About the Job This position reports to the Enhanced Care Management (ECM) Program Manager this position provides support to the ECM Program to ensure engagement, enrollment and follow up on members related to the ECM as well as other...

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...

Case Manager RN Torrance, CA, United States Salary - $51.44 to $64.87 (US Dollar) Job Summary: Salary - $51.44 to $64.87 Experience: Requires Case Management (Care Coordination or Utilization Management) in...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff...

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.

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare Home Care) Remote | Full-Time | Weekday Schedule We're building a world of health around every individual - shaping a more connected, convenient and compassionate...

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...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Acute Intake Manager - West Region - Remote (2393623) Acute Intake Manager - West Region - Remote - 2393623 Optum is a global organization...

Wellmark, Inc. is seeking a Case Management Nurse I to support members with chronic and complex health needs. You will develop individualized care plans, coordinate with providers and resources, and guide members through care pathways in a...

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...

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...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Actalent seeks a Care Management Coordinator (RN) to lead an Adult Case Management program in a primarily remote setting. You will supervise staff, drive quality initiatives, and ensure member-centered care delivery. The ideal candidate...

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...

Utilization Review Nurse - RN | 100% Remote | Part-Time 10-20 Hours Per Week | Flexible Schedule | Evenings & Weekends Looking for a way to use your nursing experience without returning to a full-time bedside...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

Umpqua Health in remote Oregon seeks a Care Coordinator to manage care for Medicaid/Medicare members. You will conduct in-home assessments, develop care plans with families and providers, and coordinate services across LTSS, behavioral health, and...

Elevance Health is seeking a Nurse Case Manager II to coordinate care for members with complex needs across multiple states. The role includes telephonic and on-site discharge planning, collaboration with Medical Directors, and development of care...

UnitedHealth Group's Optum Care at Home is hiring a Telephonic RN Case Manager to serve as primary contact for members with complex needs, conducting telephonic assessments, creating care plans, coordinating transitions, and addressing barriers to...

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...

Industry: Private Employment Type: Full Time Work Hours: 8 Hours Locations: USA Scope The Medical Review Coordinator will perform her/his duties in accordance with MedWatch procedures, MedWatch review...

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...

CorVel Corporation is seeking a Utilization Review Case Manager for a fully remote role in the United States. The position requires current nursing licensure and 4+ years of clinical experience with preferred exposure to utilization review.