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A regional healthcare organization is seeking a Level I Utilization Management Clinician to perform utilization review for medical or behavioral health requests. This fully remote position involves collaborating with healthcare teams and ensuring...

A leading health care organization is seeking a Clinical Quality Consultant to enhance Stars ratings and drive quality improvement initiatives. The ideal candidate will be a Registered Nurse with over four years of experience in the health care...

A large health service provider is seeking a Clinical Care Coordinator to ensure optimal continuity of care for patients in home health services. The role demands an Associate's degree, RN license, and at least 3 years of post-acute experience.

Remote Registered Nurse (RN) Case Manager Join to apply for the Remote Registered Nurse (RN) Case Manager role at PharmaCord. Important Notice Due to an increase in hiring scams, please be aware that if you...

Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...

A healthcare organization is seeking a Utilization Management professional to manage review processes and collaborate with leadership in Austin, Texas. The role requires a valid Texas RN license and a minimum of three years of related experience,...

At CVS Health, were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nations leading health solutions company, we reach millions...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of...

Review provider post-service appeals for Medicare and Retirement. Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines. Discuss cases with medical directors when applicable. Ability to...

A leading health company is seeking a Telephonic Nurse Case Manager II responsible for managing care for members with chronic needs. The position requires a BA/BS in a health-related field, a current RN license, and five years of clinical...

A healthcare provider in New Orleans is looking for an experienced nurse to improve clinical documentation integrity and educate providers. The ideal candidate will have a graduate degree in nursing and at least 3 years of clinical experience.

A leading healthcare organization is seeking a Utilization Management Registered Nurse 2 to support medical services coordination. This remote position requires a valid RN license, with preference for candidates with 3+ years in skilled nursing...

Employer Industry: Healthcare Why consider this job opportunity: Opportunity for career advancement and growth within the organization Work remotely from anywhere within New England Supportive and...

Liberty Healthcare seeks an experienced Registered Nurse leader for an anticipated Clinical Director opening. This is a newly created remote position which will allow you to work from your home office in Massachusetts (residency in...

A leading health solutions company is seeking a Case Manager Registered Nurse to provide quality healthcare services. This position involves conducting assessments, developing care plans, and collaborating with healthcare teams, with up to 75%...

Job Details Job Location Orange, CA - Orange, CA Remote Type Fully Remote Position Type Full Time Salary Range $45.00 - $45.00 Hourly Travel Percentage None...

A leading healthcare organization in Alexandria, VA is hiring an Integrated Nurse Case Manager for a full-time role. This work-from-home position involves conducting home visits and providing case management for members with complex conditions.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

Remote Rn Care Coach This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

Registered Nurse Disease Managers (RNDM) Spectrum Healthcare Resources has an opportunity for a Registered Nurse Disease Managers (RNDM). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be...

JOB DESCRIPTION Job Summary The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure compliance...

RN Utilization Management MCHP RN Utilization Management MCHP is responsible for the coordination of the medical care provided to Plan members with Plan providers, the member's family and other resources as appropriate. Assist in the...

A leading risk management company is seeking a caring and self-motivated RN Field Case Manager in Franklin, Tennessee. In this role, you will make a meaningful difference in the lives of injured workers, providing both telephonic and in-person...

A nonprofit health plan is seeking a Quality Outreach Case Manager to improve healthcare outcomes for members through proactive engagement and care coordination. This remote position involves conducting outreach to address member needs, providing...

Utilization Review Case Manager The University of Miami Health System Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote. The incumbent conducts...