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JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

Ardent Health is seeking a Patient Safety Manager to coordinate safety initiatives across its PSO. The role requires analyzing safety events, leading just culture, and disseminating best practices throughout the organization. The manager...

Primary Care Registered Nurse Pittsburgh, PA 15218 Description JOB SUMMARY: The Primary Care Registered Nurse will facilitate the mission of Metro Community Health Center to ensure the delivery of quality patient care and coordination of...

Description Location: UCHealth Admin 2450 Peoria, Aurora - CO Department: UCHealth Virtual Nursing FTE: Full Time, 72.00 hours per pay period (2 weeks) Shift: Day and Night Rotation Pay: $35.29 - $54.71 / hour. Pay is dependent on applicant's...

*Job Summary and Responsibilities* As our Registered Nurse (RN), 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...

CVS Health is seeking an ICM Care Manager to assess, plan and coordinate patient care from a home-based setting with 25-50% travel within Passaic County, NJ. The role requires an active NJ RN license and a minimum of 3 years clinical experience,...

Renown Health is seeking a Utilization Management RN to apply medical necessity criteria for prospective and concurrent reviews. You will work with an interdisciplinary team to ensure medically necessary, cost-effective care at the appropriate...

Case Manager Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases are maintained by Case Managers. The employee reports directly to the Supervisor, Case Management (LCSW). In addition, the role...

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

UnitedHealth Group's Optum Care at Home is hiring a Telephonic RN Case Manager to serve as primary contact for members with complex needs, conducting telephonic assessments, creating care plans, coordinating transitions, and addressing barriers to...

The Veterans Health Administration is seeking a Registered Nurse (Case Manager/Care Coordinator) at the Charleston VA Medical Center in the Nursing, Specialty department. The role focuses on complex patient management, discharge planning, and...

Home Health Clinical Referral Nurse Organization: SCAH-Sutter Care at Home - UT Position Overview: The Home Health Clinical Referral Nurse serves as the initial point of contact for potential home health patients, working closely...

Job Title: Remote Prior Authorization Registered NurseJob Description We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid)...

Healthcare Management Solutions, LLC is seeking experienced CHSD Audit reviewers to conduct independent medical record reviews for the STS CHSD program. This remote, part-time role focuses on data accuracy, source verification, and adherence to...

After Hours Service Answer Line Rn The Answer Line After Hours Service provides after-hours exchange and nurse triage services for over 300 subscribing community pediatricians in the St. Louis and surrounding areas. Answer Line RNs...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

Optum is seeking an After Hours Care Manager - LPN in California to support discharge planning, transfers, and ED diversion. This role involves telephonic coordination, collaboration with hospitalists and care teams, and ensuring timely, compliant...

Salary: $70,779.53 - $77,857.48 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2026-00669 Division: Healthcare Facility...

Trillium Health Resources is seeking a Registered Nurse to join our Utilization Management team in North Carolina. The UM reviews, coordinates care, and supports discharge planning to improve outcomes and ensure appropriate utilization of...

Maine Community Health Options is seeking a Clinical Specialist who provides clinical decision-making support and coordinates community resources to support medical management. This role analyzes documentation for medical necessity, collaborates...

Registered Nurse Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Part-Time Shift: Evenings Job Description Join a team that's shaping the...

Main Line Health, Inc. is seeking a Part-Time Nurse Practitioner/CRNP for Hospitalist VCOC to cover night shifts in a remote capacity, with some on-site training at Paoli and Bryn Mawr Hospitals. The role emphasizes acute care management,...

Ambulatory Nurse II Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading...

Yoh is seeking a Utilization Management Nurse Coordinator (RN or LVN) for a 6+ month remote contract with a managed care client based in Northern California. Training occurs onsite in Fairfield or Redding for three weeks, then transitions to fully...