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Providence is seeking a Care Management Recovery Advocate (CMRA) in Los Angeles, responsible for managing communication of clinically based appeals. The role requires an Associate's Degree in Nursing and a California Registered Nurse License.The...

Utilization Management Nurse RIHS Austin Regional Office - Austin, TX 78727 Overview Position Type Full Time Description Primary Responsibilities The Utilization Management Nurse will determine the...

Position TitleRegistered Nurse, Case ManagerLocationMontebello, CA 90640DescriptionGrow HealthyIf you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others...

Job Opportunity Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the...

Professional Nursing Care 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 health outcomes by connecting people...

Position Summary Monitors the admissions, continued stay, and discharge of patients following pre-established criteria. Assures that patients meet MCG criteria from admission to discharge including appropriateness of level of care. Conducts...

Professional Review Nurse The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical...

RN - Case Manager Case managers work to facilitate patient care by assessing patient needs, evaluating treatment options, creating treatment plans, coordinating care, and gauging progress. The overall goal for case managers is to improve...

Denials Case Manager, RN The Denials Case Manager, RN appeals all denials using InterQual criteria and medical necessity. Collaboratively works with all members of the revenue cycle team and all types of payers to resolve denials,...

Dormont Manufacturing Co is looking for a skilled Case Manager in Los Angeles, CA, to coordinate care for patients with complex needs. The role demands strong clinical assessment skills and experience in patient advocacy, ensuring that care...

AMN Healthcare Revenue Cycle is seeking a travel Utilization Review for a travel job in Woodland Hills, California. Job Description & RequirementsSpecialty: Utilization...

Company : Highmark Inc. Job Description : JOB SUMMARY This job has primary ownership and oversight over a specified panel of members that range in health status/severity...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted,...

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Annual Salary Range: $108,805.00 - $175,760.00 per yearThe FBCM Manager is responsible for overseeing the operational aspects of the FBCM team across all levels of facility-based care, including admissions at Torrance Memorial Medical Center...

Clinical Nurse Consultant As part of the Oncology Field Medical organization, the Clinical Nurse Consultant (CNC) is a trusted clinical expert responsible for developing professional relationships and educating key Health Care...

Chronic Care Manager (RN) Vitability Health of New Jersey Remote Position Our Mission At Vitability Health of New Jersey, we believe great care goes beyond checklists and...

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

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director of Nurse Case Management based in the United States. Lead a high-performing clinical...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Note - Travel Experience RequiredJob Summ aryThe Registered Nurse – Case Manager plays a pivotal role in coordinating and managing patient care throughout the healthcare continuum. This position focuses on ensuring patients receive appropriate...

Details Client Name California Hospital Medical Center Job Type Travel Offering Nursing Profession RN...

Event Details Join us for an Interview and Hiring Day! Registered Nurses welcomed! Location: 1680 E. 120th Street, Los Angeles, California 90059 Date: Tuesday, July 28, 2026 Time:...

Job Title : Registered Nurse (RN) Disease ManagerJob Overview :The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or complex health conditions. This role...