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Guidehealth is seeking a Care Manager to guide patients and families through complex health journeys. This remote role blends clinical RN expertise with holistic care, focusing on medical, behavioral, and social needs to empower wellness and...

Job Title: Clinical RN Job ID: 90637 Location: North Hollywood, California Overview: Are you a dedicated Registered Nurse who excels in outpatient clinical care and thrives in a...

Registered Nurse (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

Job Title: Clinical Prior Authorization Reviewer Job Description This role focuses on reviewing prior authorization requests to determine medical necessity and appropriate level of care in alignment with national standards,...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Utilization Management Nurse Consultant (RN) - Remote Must Reside in Oklahoma. Join a collaborative team dedicated to helping members receive the right care, at the right time, in the right setting. As a Utilization Management...

Job Description Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News & World Report's “Best Hospitals 2024-25” rankings, as well as...

Cunningham Children's Home is seeking a Nurse Case Manager to support youth in emotional, psychological, and physical care within residential settings. The position emphasizes remote on-call consultations to ensure accessibility without mandatory...

Schedule Available: 9:00 AM to 5:00 PM, Monday - Friday * With additional hours during evenings, weekends, and on-call; as needed. Benefits Include: Low patient-to-nurse...

Registered Nurse (RN) - IRIS Self-Directed Personal Care (SDPC) Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you'll want to keep...

RN Care Coordinator Care Coordination Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest...

Explore a World of Opportunity with the State of Georgia! We are the force that drives Georgia! Georgia State Government is a large enterprise, composed of various agencies and entities with a common goal to improve the lives of...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges.

Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

Cardinal Health Sonexus™ Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise...

Nurse Case Manager II - Telehealth Provides case management services to a caseload of low- and medium-risk patients. Interviews patients and their caregivers to evaluate needs, goals, and current services. Proposes process improvements...

Medical Management And Health Education Program Coordinator The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of...

Your Role The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Job Duties RSI is seeking a full-time Registered Nurse (RN) to provide nursing support to individuals with developmental, physical, and mental health needs in foster care homes throughout Duluth, East Central Minnesota, and Northern St.

Care Management Team Member The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Humana Inc. seeks a Care Manager, Telephonic Nurse 2 to assess members in a telephonic setting and coordinate care that improves wellness outcomes. The role involves independent judgment, documentation, and collaboration with multidisciplinary...

Nurse (RN) - Case Manager Hours are as needed, Monday - Friday during business hours; you will work 4, 8 or 10-hour shifts as needed to fill gaps in staffing. Hours can also include weekends but not required. This position is remote.

Delivering high-quality nursing care from a remote setting, the full-time Remote Care Nurse II will conduct patient assessments, develop care plans, and coordinate with multidisciplinary teams to optimize health outcomes using telehealth...