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Description: Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient...

A healthcare management firm is seeking an RN Care Management Coordinator – Compliance Specialist to ensure compliance with relevant regulations and standards. This remote position requires a minimum of five years of clinical experience, an...

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the...

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...

Novant Health's Population Health Services Organization (PHSO) seeks an RN Coach to guide patients through telephonic virtual care, chronic-care management, self-management support, and acute triage, delivering safe, high-quality, patient-centered...

Registered Nurse – Utilization Review (Remote) Position Overview: This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation...

Experience 2-5 years needed. Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific...

Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded...

Job ID: 33380 *Description*There's nothing more exciting and rewarding than being able to make a significant, positive difference in someone's life. At UCLA Health, you'll experience this joy every day while also enjoying the positive,...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

UnitedHealth Group is seeking a Transitional Care Nurse Liaison to educate and support high-risk patients during transitions from acute care. You will work with Boulder Community Health and partners to reduce readmissions through patient...

Registered Nurse - Utilization Review Job Opportunity: Registered Nurse - Utilization Review Facility: Providence SoCal Shared Services Case Management Location: Torrance, CA Employment Type: Travel/Contract Shift: Day (5x8 Hours) 8:00...

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...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

Job Profile Summary Location: 100% Remote, Source candidates from EST preferred but will consider CST candidates. Shift: Eastern 8-5 PM M - F with expected weekend and holiday coverage based off the team needs. This is usually every 4-5th...

Innovative Systems Group is seeking qualified healthcare professionals to conduct medical management and health education for customers on government programs. The role includes data gathering for regulatory reports and performing assessments,...

Spectrumforce Technologies, Inc. is seeking a Care Manager (RN) to support Medicaid members remotely in Florida. The role involves reviewing referrals, proactive outreach, and guiding members through care management, education, and coordinated...

A health care provider organization is seeking a Case Management Nurse to coordinate care for members. This role requires a Nursing Diploma and direct clinical experience, along with the current Michigan RN license. Responsibilities include...

About Float Float is the full-stack platform for Specialty Pharma home infusion. We're on a mission to make healthcare safer, easier, and more efficient by connecting SuperNurses to home medication visits - moving all care...

Responsive Recruiter Benefits: Competitive salary, opportunity for advancement, paid time off, training & development, wellness resources. This role is in-person in our office, located in Lake Balboa. Position Purpose The...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

Remote Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set...

Aya Healthcare has an immediate opening for the following position: Outpatient Clinic in Beverly Hills, CA.We'll work with you to build the healthcare career of your dreams. Whether you want a job close to home or across the country, we've got...

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIES: -Assess patient health problems over the phone and via secure video -Schedule appointments and refer patients -Advise and monitor...

Job Summary and Responsibilities As our RN Care Coordinator, you will be a central figure in patient care, seamlessly navigating the healthcare journey to achieve optimal outcomes and an exceptional patient...