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*Employment Type:* Full time *Shift:* 12 Hour Night Shift *Description:* Qualified applicants may submit a resume to Senior Talent Acquisition Partner, Tonya Globlek at ...@mchs.com for expedited consideration. *Position Purpose: * The...

Job Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern...

Join Our Caring Community and Prioritize Health! The Nurse for Utilization Management Appeals plays a critical role in the coordination, documentation, and communication of medical services and benefit determinations. This position...

Department WMH FRIMA-RHC - 259441Worker Sub Type RegularWork Shift First Shift (United States of America) Pay Grade Job Description Job...

Description Who we are Founded in 1999 and headquartered in Central Ohio, we're a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity...

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

The Registered Nurse Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care Manager...

Registered Nurse, Quality Assurance Reviewer The Registered Nurse, Quality Assurance Reviewer will work in conjunction with the Quality Manager and will be responsible for completing quality reviews for the Clinical Services and Provider...

20 miles from Boston - surrounding areas (Only QUALIFIED Healthcare Professionals accepted) Case Manager - Are you ready to make a real difference in people's lives while enjoying a schedule that suits your lifestyle? We're on the lookout...

Position Purpose The Transfer Center & Virtual Care RN provides leadership, accountability, and comprehensive nursing services to ensure optimal patient care, resource utilization, and seamless patient flow. This role is challenged...

Job Type Full-time Description Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and...

Job Summary: The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating...

Salary range: $95,139 - $130,811 annually, based on qualifications. This exempt remote-hybrid position is eligible for a comprehensive benefits package which includes medical, dental, vision, a 403(b) retirement account, and a generous...

Posting Date 01/26/2026 5276 Blanding BlvdSuite 26, Jacksonville, Florida, 32210-8176, United States of America RN Case Manager - Position Highlights Location: Hybrid - Remote This is a...

divh2RN Care Review Clinician/h2pThe RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

Salary: $70,779.53 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2020-02252 Division: Healthcare Facility Regulation...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions...

RN Care Review Clinician The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

Contracted Nurse Case Manager PrideStaff is looking to onboard a Nurse Case Manager, in a contingent role. We are looking for an IL licensed RN with 1-2 years of experience as a nurse case manager. This would be a short term...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for individuals facing the most complex and costly health challenges. By bridging gaps in the fragmented health care system, we...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...

Job Description The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families...

Role SnapshotOur Case Management RN (Registered Nurse) coordinates care and services of select member populations with complex health care needs across continuum of care. The primary focus of the...