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Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes...

Clinical Auditor Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes.

Job Description Harborview Medical Center has an outstanding opportunity for an experienced Registered Nurse to join our Care Management Team. WORK SCHEDULE: Full Time Day shift...

Your job is more than a job RN Care Manager - PRN - Remote You overthink every care option and scenario because, as a Care Manager, you're the hub of your patient's case management and care plan. You assure quality through...

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...

SIGN ON BONUS - $5,000 RELOCATION BONUS: (for those outside of San Diego County) - $5,000 - Bonus Available if Started prior to 06.31.2027 Job Announcement Position Title:...

Anticipated End Date: 2026-06-19 Position Title: Nurse Case Manager I Job Description: Nurse Case Manager I Carelon, a proud member of the Elevance Health family of companies, is a...

Discharge Care Manager 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 people with...

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Include:Serve as the primary point of contact and advocate for patient care, ensuring a seamless and proactive healthcare experience. Develop, implement, monitor, and revise individualized care plans in collaboration with the physician and other...

Description Manages specific patients throughout their admission to ensure the availability of sufficient clinical and medical center resources. Communicates on a daily basis with medical staff, medical center personnel and...

We are recruiting for a mission-driven RN Educator, Clinical Documentation Integrity - Must Reside in Colorado to join our team! We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something...

Job Title Provides overall supervision of the organization in collaboration with and in the absence of the administrative/executive team. Job Description Centered in the heart of Boyle Heights, Adventist Health White...

Summary VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking to hire experienced Registered Nurse to work as our Chief Nurse of Acute Care Units. As Chief Nurse, you will provide program management to ensure coordination of care,...

Nurse Reviewer At Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that...

Details Client Name Adventist Health White Memorial Job Type Travel Offering Nursing Profession RN Specialty...

City/State Newport News, VA Work Shift Multiple shifts available Overview: Sentara Health Plans is currently hiring an Integrated Nurse Case Manager in the Hampton and Newport News area of...

Nurse Investigator- Atlanta Conduct investigations (clinical mortality review) of deaths of individuals with developmental disability services. Interview witnesses, complainants, and persons of interest to obtain information...

Health Plan Nurse Coordinator The Health Plan Nurse Coordinator is a Registered Nurse who supports one or more health services operational units, such as Utilization Management, Case Management, Enhanced Care Management, Disease...

Location Address: 9521 San Mateo NEAlbuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $27.92Maximum Offer $42.63 Summary: Build your Career. Make a Difference. Presbyterian is hiring a...

Utilization Review Nurse Health Plans - Case Management US:NM:Alamogordo | Utilization Management | Full Time This position has a remote option for those living close and will be able to come into the hospital as needed.

Patient Family Liaison Clinical - RN Overview: Clinical Patient Family Liaison, Registered Nurse Location: Glendale, CA Find Your Passion and Purpose as a Full-Time Clinical...

Managing a daily caseload of Long Term Care (LTC) claims, the full-time remote Registered Nurse Claim Manager will evaluate claims for eligibility, educate policyholders on coverage, and communicate with service providers to facilitate claim...

Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We...