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Position Summary The Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective...

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...

CorVel Corporation is seeking a Utilization Review Case Manager for a remote role. The ideal candidate holds an RN license and has 4+ years of clinical experience with utilization review, CPT/ICD coding knowledge, and strong communication skills.

Molina Healthcare is seeking an RN Case Manager to join our team and support Medicare members across the Illinois service area. This telephonic role may require occasional face‑to‑face meetings and occasional local travel. The candidate...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

Centene Corporation is seeking a Licensed Practical Nurse (LPN) or Registered Nurse (RN) for a remote case management role in Pennsylvania. The selected candidate will perform concurrent reviews, determine appropriate care levels, and assist with...

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...

Seeking a full-time RN Case Manager - Remote, who will manage care for members with complex and chronic needs by assessing, developing, implementing, and evaluating care plans while working primarily through telephonic communication.Key...

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...

Brighton Health Plan Solutions is seeking an experienced Utilization Management Nurse to perform medical necessity and benefit reviews remotely, supporting both inpatient and outpatient cases. The role requires an active LPN license, strong...

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...

Kindred Hospital San Gabriel Valley Care Coordinator Kindred Hospital San Gabriel Valley is a 76-bed long-term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery...

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...

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...

CHOICES Case Management, Inc. is seeking an Administrative Assistant to support our Nurse Case Managers in a fast-paced healthcare environment. This role serves as the operational backbone, ensuring details are handled, communication flows...

Description Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the patient's placement to be at...

CVS Health is hiring an RN Case Manager for a fully remote role. You will assess, plan, implement, and coordinate case management for members, using clinical judgment and data review to reduce risks and improve wellness. Requires active RN...

Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

INTEGRIS Health in Oklahoma City, OK is seeking an experienced RN Case Manager for Utilization Review to join our remote team. This full-time daytime role includes every-other-weekend shifts and focuses on coordinating care and discharge planning.

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...

ISYS Solutions Inc. is seeking a Telephonic Case Manager - RN (remote) to provide workers' compensation case management from Augusta or surrounding areas. You will coordinate care, communicate with providers, insurers and attorneys, and document...

Medix is seeking a Remote Telephonic RN Case Manager to provide telephonic case management for chronically ill members within a C-SNP population. The role requires an active Compact State RN license or CA license and a strong commitment to patient...

HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate discharge planning within Medicare, AHCCCS, Self-pay, and other payer guidelines. The...

Hines & Associates, Inc. seeks a Registered Nurse reviewer to assess patient conditions and certify treatments according to URAC and applicable regulations. The role emphasizes clinical judgment, documentation, and collaboration with case managers...

Company Overview At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our...