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Humana is seeking a Utilization Management Nurse to support the coordination, documentation and communication of medical services and benefit determinations. This role requires clinical nursing skills and independent decision-making. You...

Guidehealth in the United States seeks an experienced RN Case Manager to work remotely with Illinois licensure. You will oversee member management, promote wellness, and support cost-effective care within a value-based care framework.

Sentara Health Administration, Inc. is seeking a Remote Integrated Case Manager. The role involves telephonic and face-to-face assessments, developing and monitoring care plans, and coordinating with health care teams to optimize patient care.

Nurse Care Manager The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while...

Medical Registrar Job Title: Medical Registrar Profession: Health Information Management Specialty: Oncology Duration: Full-Time Shift: Monday - Friday, 8 hours per shift Experience: Minimum 2 years of...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

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...

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...

ATC Candidate Medical Clearance Coordinator Serves as a member of a multidisciplinary team to provide assessment, planning, implementation, coordination, evaluation and monitoring of ATC Candidates throughout the medical clearance...

The IMA Group is seeking a Remote Telephonic Nurse Case Manager to support injured workers from home. You will assess needs via consultative evaluations and collaborate with physicians and adjusters to create cost-conscious treatment plans for...

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...

Registered Nurse Primary Care 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...

Compassionate and dedicated, the full-time Remote Bilingual Spanish Telephonic RN Case Manager will provide telephonic case management for medically complex and chronically ill members, conducting health assessments and coordinating care from a...

Humana seeks a Pre-Authorization Nurse to review prior authorization requests, perform medical necessity assessments, and educate providers on utilization processes. The role requires an active RN license (VA or compact with eNLC), 2+ years in...

Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah Preference will be given to current employees and candidates who reside in Idaho and Utah...

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,...

Case Management Nurse The Case Management Nurse delivers comprehensive, client-centered case management services across the continuum of care, ensuring that each individual receives the most appropriate level and type of health, medical,...

Veterans Health Administration in Los Angeles, within the VA Greater Los Angeles Healthcare System, seeks an experienced Registered Nurse for Inpatient Case Management on an intermittent schedule. You will assess patients, coordinate complex care,...

BAYADA Home Health Care is seeking a Clinical Manager in a remote Hawaii region to learn all aspects of clinical management under the guidance of the Clinical Manager / Rehabilitation Manager and the Director. The role requires an 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, from admission to...

Optum is seeking an After Hours Care Manager - LPN in California to support discharge planning, transfers, and ED diversion. This role involves telephonic coordination, collaboration with hospitalists and care teams, and ensuring timely, compliant...

Family Advocate Support Care - Senior Clinical Admin Nurse 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...

UnitedHealth Group's Optum Care at Home is seeking a Telephonic RN Case Manager to serve as primary contact for members with complex medical, behavioral health, functional, and social needs, coordinating care across Medicaid LTSS, home health, and...

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, from admission to...

Alignment Health invites experienced Registered Nurses to join as Telephonic Case Managers for our Special Needs Plan (SNP) members, working fully remotely from anywhere in the U.S. You will navigate care journeys, close gaps in care, and help...