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Womble Bond Dickinson (US) LLP seeks a Nurse Consultant to join our team. The Nurse Consultant provides high-level medical analysis and insight in support of legal matters, reviewing, interpreting, and synthesizing complex records into clear,...

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...

Job Description Responsibilities: Job Summary: The Case Manager oversees the process of care delivered to patients, works collaboratively, and provides leadership to the healthcare...

A health care provider organization is seeking a Case Management Nurse to coordinate care for members. This role requires a Nursing Diploma and direct clinical experience, along with the current Michigan RN license. Responsibilities include...

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...

Ascension is seeking a remote Case Management RN to review admissions and service requests for medical necessity, coordinate discharge planning, and assist staff with coding, documentation, precertification, reimbursement and denials/appeals. The...

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...

Elevance Health is seeking a Telephonic Nurse Case Manager I to provide remote care management for members with complex and chronic conditions. The role requires a BA/BS in a health-related field, a current RN license, and multi-state licensure...

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.

A leading healthcare staffing firm in Florida seeks a dedicated RN for telephonic care management. The ideal candidate will have over 2 years of clinical nursing experience in an acute care setting and proficiency in case management.

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...

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...

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...

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.

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.

Summit Consulting seeks a skilled Registered Nurse with strong case management and managed care experience to review and optimize workers' compensation claims. The role involves auditing medical bills, advising on cost-control procedures, and...

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...

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...

OverviewStart your day from a home office!2-3 assessments per day! About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care...

HealthEdge is seeking a motivated Utilization Review RN to join our team. You will perform prospective, concurrent and retrospective reviews of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, length of stay...

The Elevance Health Companies, Inc. in California is seeking a Telephonic Nurse Case Manager II to assess, plan and coordinate care for members with complex needs. This hybrid/remote role allows remote work with required in-person training...

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after training: M-F...

Engage patients telephonically to assess needs and prioritize care.Collaborate with providers to coordinate care and transitions.Provide education and resources to patients and caregivers.What Will Make You Successful Here: Hold an active RN...

Our Story Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America, we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier...

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...