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Bring clinical insight, nursing expertise, and data-driven precision to a Hybrid/Remote Clinical Documentation Improvement Nurse Specialist career that combines meaningful patient impact, supportive leadership, modern healthcare technology,...

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,...

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...

HealthMap seeks a Care Navigator to manage kidney health care for a mixed caseload, coordinating with physicians, nurses, and other care team members. You will document in Compass, perform screenings, maintenance of care plans, and address...

OPCO Skilled Management is seeking a Central Intake Nurse for a remote, full-time role. You will collect referral documentation from physicians, insurers, and providers to determine service appropriateness and coordinate patient care plans with...

Where You'll Work Founded in 1923, Dignity Health - St. Mary Medical Center is a 389-bed, acute care, nonprofit hospital located in Long Beach, California. Serving over 80,000 patients annually, the hospital offers a full...

BHU Intake Nurse Coordinator (RN)Job Title: BHU Intake Nurse Coordinator (RN) - Per Diem: 1 shift per week, weekend availability requiredBase Rate: $41.73- $61.3512 hr. shifts- paid overtime after 8 hours, resulting in an average rate of $48.69 -...

OpTech is seeking a Registered Nurse (RN) to support utilization review and clinical review activities for a Michigan health plan. This role involves evaluating medical services for medical necessity, level of care, and clinical criteria. The...

Registered Nurse (RN) Schedule Available: 9:00 AM to 5:00 PM, Monday - Friday. With additional hours during evenings, weekends, and on-call; as needed. Benefits Include: Low patient-to-nurse ratio...

Market leading managed care organization looking for remote RN Case Managers! Great opportunity, please call us today! Must RESIDE in Oklahoma and must have an active and unrestricted Oklahoma RN license Location: Remote ...

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...

Nurse Case Manager Responsibilities The Nurse Case Manager shall provide a full range of professional health nursing principles, practices, and procedures in clinical settings in order to analyze the full scope of problems...

Cunningham Children's Home in Urbana, IL is seeking a Nurse Case Manager to support youth in emotional, psychological, and physical care across residential services. This role emphasizes medical case management, screening, education, counseling,...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the...

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...

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...

Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the bedside while still making a massive impact on patient care? We are seeking a dedicated Utilization Review Nurse to join our...

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...

Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential At Concierge Home Care, we are growing and looking for an experienced Utilization Review Specialist (RN) to join our remote home health...

TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services.

NCA is in search of a Nurse Case Manager based in Los Angeles who will be responsible for case management services responsive to special needs and eldercare client care and quality of life challenges and collaboration with the primary family...

Genex Service LLC in El Monte, CA hires a Medical Field Case Manager to coordinate in-person patient appointments, collaborate with treating physicians and employers, and develop treatment plans aimed at quick, safe return-to-work. The role...

The Clinical Quality Assurance Coordinator is responsible for ensuring case reports are of the highest quality and integrity, and in full compliance with client contractual agreements, regulatory agency standards and federal and state mandates.

Optum is seeking a Registered Nurse with managed care experience to evaluate outpatient services and determine appropriate care in a remote role within the United States. You will translate complex medical guidelines into actionable care decisions...