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Utilization Management Nurse Consultant Clinical Precertification RN (Medicare- Complex Spine Team) We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At...

JOB REQUIREMENTS: -Experience: 3 years acute care case manager experience -CA RN License -Certs: BLS -**FLU VACCINE (no exemptions)** Flu season starts September -Special Requirements: EPIC highly preferred. Due to nature of...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding experienced RNs to its clinical...

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This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Care Management Team Member The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

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...

Supports the values of service excellence, teamwork, and integrity while managing patient care.Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers.Qualifications:Requires a current RN license, nursing diploma or...

Overview Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the...

CVS Health Corporation seeks a Remote UM Nurse Consultant RN Precertification Nurse (Telework) to review clinical information, coordinate with providers, and authorize services under evidence-based criteria. The role is full-time, remote,...

Utilization Management RN Reviewer Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

Private Health Management is seeking a Nurse Advisor to guide clients through complex healthcare journeys, educating and advocating for high‑quality care. You'll coordinate care, support families, and collaborate with clinical and operations...

Mercor connects elite creative and technical talent with leading AI research labs. A remote Utilisation Management leader role is available, requiring RN licensure and physician-advisor experience. Contract position with high-level...

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform both inpatient and outpatient...

Randstad USA is seeking a hybrid RN Case Manager in the greater Arlington, VA area. This role blends home-based and field work, covering Falls Church, Annandale, Springfield, Arlington, Alexandria; mileage reimbursed. The ideal candidate...

Benefits: 401(k) Competitive salary Dental insurance Health insurance Paid time off Signing bonus Training & development Vision insurance Outpatient Case Management West Los Angeles VAMC 11301...

Compassus is seeking a Hospice RN Clinical Coordinator to oversee administrative and management functions in the absence of the Director of Clinical Services. May carry caseload and ensure compliance with state and federal regulations. Remote role...

Humana is seeking an RN, Field Care Manager 2 (Physical Health) to assess member needs, develop care plans, and coordinate services across the care team. This role operates primarily in the field with remote/home office duties when not visiting...

Employment Type: Full time Description: Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices &...

Aurora Health Care in Milwaukee, WI seeks an experienced Registered Nurse for a Transitional Care Manager role, focused on high-risk patients during discharge and the 30-day post-discharge period. You will assess needs, develop care plans,...

RN Utilization Review Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the...

JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory...