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Telephonic Nurse Case Manager As a Telephonic Nurse Case Manager, you will assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers.

Job Description: Job Title: Clinical Quality Reviewer RN (Quality of Care Review) Duration: 9+ Months (Potential Extension and Conversion to FTE) Location: Remote - CA Work Schedule: Monday - Friday | 8:00 AM - 4:30 PM / 5:00 PM...

RN Clinical Nurse The RN Clinical Nurse provides patient-centered, specialized, evidence-based nursing care across the continuum through an interprofessional approach to treatment, research, education, and advocacy. Contributes to the...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

Care Coordinator 2 (Field Care Manager 2) Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness...

Clinical expertise meets analytical precision in a role that directly shapes how patient care is captured, understood, and valued across the health system. As a Clinical Documentation Specialist, you bring a seasoned nursing perspective into a...

" The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal...

Job Summary and ResponsibilitiesAs our Educator, RN in Periop, in accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position serves as a consultant/resource professional by providing staff...

On-Site Care Coordinator This is a remote position with travel required within Spartanburg, SC Territory/Community. Mileage is reimbursed for travel. Position Summary: The On-site Care Coordinator is a Registered Nurse who provides...

Responsible for collaborating with healthcare providers and physicians for problem solving, prioritizing and facilitating patient care objectives, the coordination and...

Business Area Manager 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 purpose. If...

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...

Utilization Review RN - Remote This position is Full-time and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical...

Job Opportunity Title RN Date Opened 03/18/2026 Job Type Local/Travel Contract Industry Health Care Work Experience 1+ year City Northridge State/Province California Country United States...

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...

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...

At EVERSANA, we are proud to be certified as a Great Place to Work across the globe. We're fueled by our vision to create a healthier world. How? Our global team of more than 7,000 employees is committed to creating and delivering next-generation...

Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital as needed. The Utilization Review Nurse is responsible for determining the clinical appropriateness of...

Job Opportunity Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the...

Clinical Nurse Consultant As part of the Oncology Field Medical organization, the Clinical Nurse Consultant (CNC) is a trusted clinical expert responsible for developing professional relationships and educating key Health Care...

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

Description & Requirements Maximus is hiring a Clinical Reviewer RN/LPN to support our LTSS Tennessee contract. Areas will include but are not limited to PASRR Level 1 and Katie Beckett. In this role, you will review...

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

Job Details Telephonic Triage Nurse Case Manager (Remote) 2026-1475 Dallas, TX, USA Medical Case Management Full Time Description Overview Are you looking to make a difference by providing...

Registered Nurse (RN) – Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are seeking an experienced Registered Nurse (RN) to support our 24/7 Utilization...