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Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

Molina Healthcare is seeking an experienced RN Care Manager to support care coordination across the continuum of member care. You will collaborate with the multidisciplinary team, assess member needs, implement care plans, and monitor progress to...

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...

Overview TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety...

*Job Summary and Responsibilities* As our Nurse Shfit Manager, you will be a pivotal health care professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

Cadence in Dallas, TX is seeking an RN Supervisor to lead a remote team of Registered Nurses in a high-volume triage environment. This role demands strong clinical judgment, operational management, and performance coaching to maintain quality...

A healthcare organization is seeking an RN Case Manager to work remotely and facilitate case management activities, evaluating medical needs for overall member wellness. Candidates should have an active RN license, ideally compact, with at least...

TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated...

A healthcare solutions provider is seeking an experienced Nurse Advocate to work remotely from Kansas. The ideal candidate will possess a nursing license and have at least 3 years of experience. Responsibilities include assisting clients in...

A health care provider organization is seeking a Case Management Nurse to coordinate care for members. This role requires a Nursing Diploma and direct clinical experience, along with the current Michigan RN license. Responsibilities include...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and...

Central Health seeks a Nurse Case Manager to identify, screen, track and coordinate care for members with multiple co-morbidities and psychosocial needs. This role may work remotely with occasional travel to Austin, TX, under the Manager of Case...

A healthcare recruitment firm is seeking a Lead Healthcare Recruiter (Utilization Management RN) for a remote 6-month contract. The ideal candidate will have an active RN license and experience with health plan operations. Responsibilities include...

Sagility in the United States is seeking a Training Manager (RN) to oversee the end-to-end delivery of clinical training programs and ensure learners achieve readiness and performance outcomes. You will align training with client experience,...

A leading healthcare company is seeking an experienced Telephonic Nurse Case Manager to manage medical claims and facilitate care for injured workers. The ideal candidate will have at least a year of experience in Florida Workers' Compensation,...

Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

General Information Press space or enter keys to toggle section visibility Work Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

To support a growing healthcare team, the full-time Remote RN Care Manager will manage an assigned patient panel, focusing on individual healthcare needs, collaborating with interdisciplinary teams, and advocating for patients while working...

Optum is seeking an Utilization Management Nurse to review medical records, extract key case details, and craft defensible appeal letters in line with process instructions and guidelines. The role requires an RN with an associate degree, 3+...

Event Details Join us for an Interview and Hiring Day! Registered Nurses welcomed! Location : 1680 E. 120th Street, Los Angeles, California 90059 Date : Tuesday, September 29, 2026 Time : 9:00 am to 2:00 pm Directions/Parking: Our main lobby entrance...

Centene Corporation is seeking a remote Mississippi-based Registered Nurse to develop and manage complex care plans for members, coordinating with providers and families to ensure timely, person-centered care. The role emphasizes ongoing...

An established industry player is seeking a dedicated Registered Nurse for a remote contract position focused on reviewing medical claims within the insurance sector. This role involves validating treatment plans using accepted criteria and...

Description: About Us Hines is a nationwide, independent leader in personalized managed health care, focused on what's important to you—comprehensive services with the program excellence and cost containment that you demand. Hines & Associates,...

Guidehealth is seeking a remote Care Manager who can blend clinical nursing expertise with holistic patient care. You will guide patients and families through complex health journeys, coordinate care across providers, and empower members with...