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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...

To ensure timely and accurate care decisions, the full-time Utilization Review Nurse LVN/LPN will perform clinical reviews for medical necessity and benefit coverage, applying clinical guidelines and maintaining compliance in a remote work...

Care Manager At UnitedHealthcare, we're 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 (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

52272794 Overview Remote Registered Nurse (RN) DH Direct Triage Part-Time, 20 hours per week Position Summary The RN - DH Direct Triage provides high-quality,...

Position Purpose: Performs care management duties to assess, plan and coordinate aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality and cost effective care.

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

Host Healthcare is seeking a local contract nurse RN Case Management for a local contract nursing job in Paramount, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 11/02/2026 Duration: 13 weeks 40...

WORK REMOTELY after training! CANDIDATE MUST RESIDE IN THE METROPOLITAN NEW YORK AREA! !! Process all requests for services in accordance with Medicare and NYS Medicaid guidelines as well as departmental criteria and...

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...

Nursing Scheduler / Payroll clerk THIS POSITION IS ON SITE ONLY NO REMOTE WORK Summary/Objective The Human Resources Assistant supports the Human Resources Manager by completing payroll processing , performing clerical tasks , and carrying out...

Careers With Purpose Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. Facility: Bismarck Med Ctr...

Case Management Utilization Management Great care starts with great people. (Like you.) At HonorHealth, you'll find something special. From humble beginnings in 1927 to one of Arizona's largest nonprofit healthcare systems, our...

Central Intake Nurse Job Type: Full-Time Remote possible Benefits Offered: Healthcare Dental Vision PTO 401K Your Job Summary The Central Intake Nurse...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

Part-Time Nurse Second Baptist School University-Model® (SBSUM) is currently seeking a Part-Time Nurse for the 2026-2027 school year. This role serves in a variety of capacities including UM campus support and administrative support.

Extraordinary Careers. Endless Possibilities. With the nation's largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion...

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

Virtual Care Registered Nurse We are seeking a licensed Registered Nurse to deliver virtual care to patients on behalf of one of our partner organizations. This role involves delivering remote patient care, symptom triage, health...

Wound Care LVN - Regional Travel Skilled Wound Care | Los Angeles, CA + Extensive Regional Travel | Full-Time | $75,000 - 90,000 + Quarterly Bonus...

Telephonic Nurse Case Manager II Location - California - Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and...

Inpatient Nurse Informaticist / Clinical Annotation Specialist Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve...

Build relationships with patients based on trust and motivational communication techniques.Triage vital signs and collaborate with care teams to set patient-centric health goals.Responsibilities:Manage physiological markers and patient messaging...

Provides direct nursing care including assessments, care plan, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of...

Find your calling at Mercy! Provides on call registered nursing support outside of regular business hours to meet patient care and operational needs across assigned departments or service lines. Utilizes clinical nursing knowledge and judgment to...