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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...

CVS Health Aetna Case Manager RN At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health...

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's...

Join our award winning culture as we serve members in your area! Position Summary: The RN Care Manager (RN CM), as part of an interdisciplinary team (IDT) with a Care Manager, serves Lakeland Care's...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with...

Description Location: This position is located at our Dublin, OH campus with hybrid flexibility. Rotating work from home days. No weekends or holidays Who we are Founded in 1999 and headquartered in Central Ohio, we're a...

Providence Health Plan Caregiver Opportunity Providence Health Plan caregivers are invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding,...

Details Client Name Ohio State University Hospital East Job Type Travel Offering Nursing Profession RN...

Hospice Clinical Liaison Connect care. Guide families. Make every day count. We are seeking an experienced and compassionate Hospice Clinical Liaison to join our team. In this role, you will ensure that intake and referral...

A healthcare services provider is seeking a Remote RN Case Manager to work from home in Chicago, Illinois. In this role, you will enhance member management, promote wellness, and assist in navigating the healthcare system. Responsibilities include...

Overview Full-time days Are you looking for a rewarding career in homecare? If so, we invite you to join our team at Amedisys, one of the largest and most trusted home health and hospice companies in the U.S.

CVS Health Aetna Case Manager RN At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health...

CVS Health Aetna Case Manager RN At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading...

Remote HEDIS Nurse Consultant Description HEDIS work typically includes requesting records, abstracting/overreading medical records, performing claims research, preparing medical records for the NCQA HEDIS Auditor, etc. Abstracts...

What you'll do at DBH: As a Mental Health/Psychiatric RN you will: * Serve in a fundamental role as an interdisciplinary treatment team member for psychiatric patients creating and executing treatment plans * Observe, evaluate,...

Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1) Organization: Medicaid Work Location: Lazarus 5, 50 West Town Street, Columbus, 43215 Primary Location: United States of America-OHIO-Franklin...

Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...

Nursing Operations Manager, Provider Services Soleo Health is seeking a Nursing Operations Manager, Provider Services in Dublin, OH. Join us in Simplifying Complex care! Soleo Health Perks: Competitive...

A prominent health care provider in Boston is seeking a part-time Population Health Nurse to manage patient engagement in the Remote Blood Pressure Monitoring initiative. Responsibilities include serving as the clinical contact, coordinating care,...

CVS Health Aetna Case Manager RN At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health...

CVS Health Aetna Case Manager RN At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health...

Registered Nurse/Case Manager Duration: 13 Weeks Start: 07/14/2025 Shift: Day 5x8-Hour (08:00 - 16:30) Description: Registered Nurse Case Manager coordinates patient care by developing, implementing, and evaluating personalized...

Our culture and people are what set us apart from other post-acute care providers. We're dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY. ...

Overview: Typical Schedule: Monday-Friday, 7a-3:30p, 40 hrs./week. *Position is exempt. Job Description Summary: Manages the onboarding process, supervises competency processes, and...

Details Client Name The James Cancer Hospital and Solove Research Institute Job Type Travel Offering Nursing Profession RN...