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Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

ISYS Case Management seeks a Telephonic Case Manager—RN with active licensure and CMSA-aligned experience in workers' compensation. This remote role supports injured workers, coordinating care, documenting progress, and communicating with...

Manage CMS and State Administering Agency audits for PACE compliance.Ensure audit readiness and serve as point with audit teams.Champion compliance culture across the organization.Key Responsibilities:Monitor audit universe data and review...

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management in a remote, work-from-home role. You will review clinical data, apply guidelines and collaborate with care teams to ensure appropriate, high-quality,...

The Veterans Health Administration is seeking a Registered Nurse (Case Manager/Care Coordinator) at the Charleston VA Medical Center in the Nursing, Specialty department. The role focuses on complex patient management, discharge planning, and...

To assist injured workers in receiving timely and appropriate medical care, the full-time Remote RN Telephonic Case Manager will assess, plan, implement, and coordinate care while working Monday through Friday from 8:30 am to 5:30 pm local...

Stability Healthcare is seeking a local contract nurse RN Home Health for a local contract nursing job in Torrance, California. Job Description & RequirementsSpecialty:...

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...

Opco-Skilled-Management- is seeking a Central Intake Nurse to coordinate initial and ongoing referral documentation from physicians, insurers, and providers to determine service appropriateness and facility placement. You will develop patient care...

Home Health Clinical Referral NurseOrganization: SCAH-Sutter Care at Home - UTPosition Overview: The Home Health Clinical Referral Nurse serves as the initial point of contact for potential home health patients, working closely with our clerical...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

Chronic Care Coordinator Location: MICHIGAN - 100% REMOTE (NOT A COMPACT STATE) Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing...

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...

Salary: $70,779.53 - $77,857.48 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2026-00669 Division: Healthcare Facility...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will...

Case Manager Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases are maintained by Case Managers. The employee reports directly to the Supervisor, Case Management (LCSW). In addition, the role...

UnitedHealth Group is seeking a Patient Care Coordinator to support the National Start of Care Nursing Team. The role involves nursing coordination for infusion services, managing referrals, intake and patient management, and coordinating with...

Float Health is seeking an Intake Specialist to manage new patient referrals and coordinate start-of-care visits. This externally facing role requires quick action, clear communication, and meticulous attention to detail to ensure timely,...

Join UnitedHealthcareAt UnitedHealthcare, we are 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...

Registered Nurse – Care Management (Remote) (Day Schedule) United States Job Title: Registered Nurse – Care Management (Day Schedule) Location: 100% Remote - United States Employment...

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.

Atrius Health, part of the Optum family, seeks an experienced Registered Nurse to deliver patient care remotely in Massachusetts, aligning with RN protocols and evidence-based practice. In this role, you will build therapeutic...

Renown Health is seeking a Utilization Management RN to apply medical necessity criteria for prospective and concurrent reviews. You will work with an interdisciplinary team to ensure medically necessary, cost-effective care at the appropriate...

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...