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NeueHealth is a value‑driven healthcare company grounded in the belief that all health consumers are entitled to high‑quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make...

Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued theyre invaluable. Join our team at...

Registered Nurse (RN) – Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the right care at the right time.

AMN Healthcare Revenue Cycle is seeking a travel Utilization Review for a travel job in Woodland Hills, California. Job Description & RequirementsSpecialty: Utilization...

Care Manager The Care Manager is responsible for providing care management to a group of health plan members, creating the Person-Centered Service Plan (PCSP), coordinating services, and documenting care in accordance with health plan...

TitleNurse EducatorLocationBased out of any of our sites in California: Torrance, North Hollywood, Colton, San Diego, or Sacramento. This position is in‑person.Salary Range$105,000 - $128,500 annuallyEmployment TypeFull‑TimeBenefitsMedical,...

Grow HealthyIf you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to...

The University of Southern California (USC), founded in 1880, is the largest private employer in the City of Los Angeles. As an employee of USC, you will be a part of a world-class research university and a member of the "Trojan Family," which is...

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 on government health care programs. Accountabilities include...

Payment Integrity Nurse – Medicare Advantage We are currently hiring for a Payment Integrity Nurse – Medicare Advantage to join BlueCross BlueShield of South Carolina. In this role as a Payment Integrity Nurse, you will...

Nurse Reviewer 1 Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes...

Clinical Case Manager Opportunity Are you ready to bring your expert clinical skills to a world-class facility recognized as one of the top ten in the United States? Do you have a passion for the highest quality and patient happiness?

Working remotely, the full-time RN Utilization Management will review and document member case histories and prior authorization requests, utilizing clinical judgment to determine coverage eligibility while ensuring compliance with policies and...

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...

Denials Case Manager, RN The Denials Case Manager, RN appeals all denials using InterQual criteria and medical necessity. Collaboratively works with all members of the revenue cycle team and all types of payers to resolve denials,...

Overview Your Role: The Nurse Educator is responsible for providing support to ensure safe, effective and appropriate use of PROVENGE® (Sipuleucel-T) (the “Product”) from enrollment to completed infusion for...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted,...

Yourcommission is seeking qualified candidates for nursing roles in Beverly Hills, California. Applicants must have a valid RN license and a Bachelor of Science in Nursing. Experience in acute care nursing and case management is preferred.The role...

Under the general supervision of the Patient Hub Director and Manager, the Higher Level of Care (HLOC) and Special Projects RN functions independently in assisting all of Pipeline's hospital case management departments with facilitating all patients...

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Position TitleRegistered Nurse, Case ManagerLocationMontebello, CA 90640DescriptionGrow HealthyIf you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others...

A Registed Nurse Care Manager (RNCTM) contributes to AHF by satisfying the AHF Core Measure of being Patient Centered, regulatory & contractual compliance requirements and AHF's North Star mission. The RNCTM position focuses on removing access to...

Company : Highmark Inc. Job Description : JOB SUMMARY This job has primary ownership and oversight over a specified panel of members that range in health status/severity...

Chronic Care Manager (RN) Vitability Health of New Jersey Remote Position Our Mission At Vitability Health of New Jersey, we believe great care goes beyond checklists and...

Clinical Nurse Educator The Clinical Nurse Educator is located at Central Virginia VA Health Care System, Richmond, Virginia. Clinical Nurse Educator is responsible for providing competent, evidence based education to staff. The incumbent...