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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...

Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides...

Centene Corporation in Wisconsin is seeking an Appeals Liaison to coordinate statewide appeals, fair hearings, and external reviews. You will ensure letters meet State and NCQA requirements and work with Medical Directors to clarify medical...

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...

Why Brighton PRN/REMOTE At Brighton/Suncrest Hospice our goal is to change the expectation of hospice care in your area by providing exceptional care and service to our patients. This is achieved by allocating the resources to...

WNS Healthhelp in the United States is seeking an RN/LVN Team Lead to oversee utilization management and case coordination. You will balance review work with leadership duties, monitor staffing, and ensure regulatory compliance across programs.

Sentara Health in Richmond, VA is seeking an Integrated Case Manager, RN on a full-time basis. This role combines remote work with required in-person assessments and regional travel to partner sites. The nurse will oversee care plans,...

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 Wellstar, our mission is simple, yet powerful: to enhance the health and...

Brighton Health Plan Solutions, LLC seeks a Complex Case Manager (RN) to oversee a caseload of members with complex medical and care coordination needs. The role reports to the Supervisor, Case Management and collaborates with the Senior Director,...

Sedgwick is hiring a Telephonic Case Manager (US Telecommuter) to support injured workers by planning medical care and advocating for timely returns to work. You will assess needs over the phone, coordinate services, and communicate with care...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing...

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.

Behavioral Health Manager, Nurse Practitioner-Integrated Care Delivery (NP-ICD) Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That...

Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides...

The Neuron Clinic in California is seeking an experienced infusion nurse with leadership abilities to join our busy outpatient neurology practice. This full-time role focuses on care management within CCM and PCM programs, managing a patient panel...

Humana Inc. seeks a Telephonic Registered Nurse Care Manager to work from home, guiding patients through post-acute care options and coordinating with the CenterWell Home Health clinical team. The role focuses on ensuring continuity of care and...

Molina Healthcare is seeking a licensed RN Case Manager in Texas to support women's health and LTSS coordination from a home-based setting. You will evaluate member needs and lead care coordination for high-risk pregnancies, using the Molina...

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude...

Cincinnati Children's is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department.

UnitedHealth Group is seeking a Clinical Grievances Nurse to review retrospective cases for appropriate care and address members' immediate needs. The role embraces remote PST hours with an on-site base in Mesa, AZ, requiring CA residency and an...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

Spectrumforce Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for a 3-month contract to hire. The role is remote with work location listed as Remote-MS CST, schedule 8 am-5 pm Central time, with occasional weekend...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

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.