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Senior Specialist, Quality Improvement (Registered Nurse) Reason for opening: FTE support needed for "Q4 Push" to close Medicare/MMP gaps in care with member & community events Will this role be fully remote? Yes Are there...

Your Role The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans,...

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,...

Job Title Utilization Management Team Leader Job Description The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical...

Alliance Health is seeking an UM Clinical Specialist RN for Physical Health who works remote with NC-based residency and occasional travel for in-person meetings. The role focuses on medical necessity reviews for inpatient and outpatient services,...

Nurse Case Manager IIDo you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.The Nurse Case...

Business Area Manager (Nursing) Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

Registered Nurse (RN) for Utilization Management Team We are seeking a Registered Nurse (RN) to join our Utilization Management team. In this role, you will perform concurrent reviews, prior authorizations, medical necessity reviews,...

Nurse Care Manager Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's shaping the...

Salvo Health has a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions from IBS to obesity. Our patients are assigned a "whole patient" care team and have seven day a...

American Career College, we share a passion for students and...

Details Client Name Ronald Reagan UCLA Medical Center Job Type Travel Offering Nursing Profession RN...

RN - Case Manager About the Position Specialty: RN Case Manager Experience: 1+ year of recent case management or discharge planning experience preferred License:...

RN Care Manager *F/T Variable* Santa Monica, California Full Time RN Care Manager with our Care Management Team at our Cedars-Sinai Tarzana Medical Center in Tarzana, CA. This is a full-time position that will work 8-hour...

The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This includes conducting patient evaluations, managing admissions and informational visits, and ensuring timely...

Case Management RN Travel profession RN. Start date 09/14/2026, end date 02/22/2027, duration 23 weeks. Located in West Hills, CA. Equal opportunity employer. All qualified candidates are encouraged to apply. Information provided...

A healthcare organization is looking for a Case Manager Nurse Advocate in the Greater Charlotte Area, NC. The role involves aiding clients in navigating their healthcare needs while working remotely. Candidates should possess a nursing license,...

Telephonic Case Manager RN 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...

At St. Luke's, our dedicated team of Remote Patient Management RNs are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which...

RN / Registered Nurse Case Management in Torrance, CA Location: Torrance, CA, USA Setting: Hospital Job Type: Traveler Description: Estimated payment breakdown $2,244 per week in taxable pay...

A healthcare services provider is seeking a Nurse Liaison who will act as a pivotal communication link among injured workers, insurers, and care providers. This role requires a skilled nurse to coordinate care and ensure efficient treatment.

Posting Date 07/31/2026 1150 Lake Hearn Dr NeSte 100, Atlanta, Georgia, 30342-1566, United States of America RN Case Manager - Position Highlights Location: Atlanta, GA - Remote...

Job Description The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace the care for outcomes while meeting...

Details Client Name Kaiser Permanente Los Angeles Medical Center Job Type Permanent Offering Nursing Profession Nurse...