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Full Time Days 7am-4:30pm 40 Hours/Week Utilization management and pediatric nursing experience preferred Summary: The Utilization Management Nurse is responsible for conducting medical necessity...

Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital as needed. The Utilization Review Nurse is responsible for determining the clinical appropriateness of...

Registered Nurse-Utilization Review Job ID #2038951 | Share About this Role As a Utilization Review Registered Nurse (RN) supporting a health plan or insurance organization, you will use your...

About Abby Care: Powering the Future of Care at Home for All of America Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever.

Cedars-Sinai is seeking a Case Manager to oversee patient care from admission through discharge across inpatient settings. You will assess needs, coordinate care, and collaborate with hospitalists to ensure medical necessity and appropriate level...

Saint Luke's Is Looking To Add To The Ur Team! Schedule: Day Shift Status: PRN - 1 shift required every 2 weeks The Opportunity: The Utilization Review RN is responsible for assuring the receipt of high quality, cost...

At Premier Home Health Providers Inc., our compassionate and experienced clinicians are certified and expertly trained to help you manage your condition, prevent rehospitalizations, and improve your health and quality of life in the comfort and...

Care Manager—Registered Nurse 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...

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...

RN Case Manager Qualifications for RN Case Manager: The Case Manager is responsible for managing a continuum of care from admission through discharge for assigned patients. Partners with medical staff, utilizes...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients' severity of illness is accurately portrayed in the medical record for specificity of...

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit,...

Registered Nurse - Case Management Duration:13 Weeks Start:03/10/2025 Job Type: Travel Minimum Guaranteed Hours: 40 Jobs Notes: Day Shift, inpatient RN CM Acute hospital experience,...

Job Details Telephonic Triage Nurse Case Manager (Remote) 2026-1475 Dallas, TX, USA Medical Case Management Full Time Description Overview Are you looking to make a difference by providing...

Summary The Greater Los Angeles Health Care Systems is seeking an experienced Registered Nurse to serve in Outpatient Mental Health for the Caregiver Support Program specialty within Nursing, Mental Health Department. The Caregiver Support Program...

Description Telephonic Nurse Case Manager (1099 Remote - NJ RN License Required) We are currently seeking an experienced Telephonic Nurse Case Manager (RN) to support workers'...

Job Summary: The LVN Case Manager works under the direction of an RN following assessment, planning, facilitation and advocacy, which are achieved through collaboration with the client and other health care...

Description Job Summary:Under the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, acting as a resource to staff and physicians in resource efficiencies...

Job Description The Team Manager is the leader of the Patient Care Team and that member of the team whose function is to: supervise, evaluate and coordinate the various component members of the interdisciplinary team; assure...

Job Opportunity Our client is a private health management company devoted to providing an exceptional clinical team in the comfort, and privacy of a patient's own home. We are seeking dynamic, experienced, and compassionate Registered...

Job Description The RN Utilization Management (RN UM) functions as a support liaison for a variety of UM functions which may include the e‑TAR process, denials management, and the UM process.The RN UM coordinates care submission relating to the...

Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13208 Salary Range:...

RN Clinical Nurse The RN Clinical Nurse provides patient-centered, specialized, evidence-based nursing care across the continuum through an interprofessional approach to treatment, research, education, and advocacy. Contributes to the...

JOB SUMMARY Registered Nurses deliver care to patients utilizing the nursing process. Nurses collaborate with other professional disciplines to ensure effective patient care delivery and achievement of desired patient...