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Description RN- Registered Nurse - Case Manager Specialty: Case Manager Location: Los Angeles,CA,00000 Start Date: 2026-10-19 End...

Nurse - Clinical Review The Clinical Review Nurse makes prospective medical necessity determinations on prior authorization requests for HealthHelp's specialty programs, including Diagnostic Imaging, Cardiology, Musculoskeletal, Physical...

Job Title: Registered Nurse (RN) - Utilization Management Location: Remote in NJ Job Duration: 3 months contract (possible extension) Schedule: Regular Business Hours Pay Rate: $40/hr. on...

Optum Home & Community Care is seeking an RN Utilization Management Nurse in the greater Washington, DC area. The role reviews PDN/PCS authorizations and uses evidence-based criteria to determine medical necessity. You will coordinate with...

Registered Nurse (RN) - Utilization Management Location: Remote in NJ Job Duration: 3 months contract (possible extension) Schedule: Regular Business Hours Pay Rate: $40/hr. on W2 Job Description: ...

Registered Nurse (RN) - Utilization Management 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...

Care Manager Registered Nurse (CMRN) At Hopscotch Primary Care, we believe great healthcare should be accessible to all people across all communities. Today, almost 20% of Americans live in a rural community, yet only 11% of physicians...

Job Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

Description: Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital, three medical office buildings, residency programs,...

McLaren Health Care is seeking a Registered Nurse to join the Utilization Management team. The role focuses on determining appropriate patient status, ensuring medical necessity, and documenting care for insurance and government payers within an...

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Inpatient Care Management Nurse 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...

Remote National Remote Full time R0056005 At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote...

*Job Summary and Responsibilities* As our surgical services nurse at Glendale Memorial Medical Center you will prepare patients for surgical procedures and assist in the operating room to ensure they receive excellent nursing when they are at...

RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable...

Utilization Management Policy Initiatives Nurse RN II The Utilization Management Policy Initiatives Nurse RN II, under the purview of the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing,...

Clinical Nurse, Medical Management/Utilization Management Saratoga Medical is hiring for a Clinical Nurse, Medical Management/Utilization Management in Falls Church, Virginia. Package includes competitive rate, paid time off and benefit...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end...

Please make sure to complete all the questions in the application and continue through to the end in order to sign and submit it. The preferred work hours are 8:30 am / 9 am - 5 pm / 5:30 pm central time...

Summary Home Telehealth Care Coordinator (HTCC) Registered Nurse (RN) demonstrates leadership - experience - and creative approaches to management of complex patient care. The HTCC is responsible for coordination of health care for a...

Care Manager Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will...

Nurse Disease Management II Nurse Disease Management II Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach...

Nurses - are you looking for a change? Want to work no nights, and no holidays? Check out Hines & Associates! ABOUT US: Hines is a nationwide, independent leader in personalized managed health care,...

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults-and we're looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living...

Sentara Health Plans seeks a Clinical Claims Reviewer RN for remote work. You will perform utilization management, review pre/post payment claims and authorizations for inpatient/outpatient cases, and address provider inquiries with appropriate...