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Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and...

RN Clinical Appeals Nurse Job Summary: The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory...

Registered Nurses are encouraged to consider a part-time remote Nurse Reviewer position with Liberty Healthcare Corporation. Liberty Healthcare operates a statewide program in Idaho which assesses children and adults who are living with...

Care Advocate (RN) - Florida Papa is a new kind of care built on human connection. Across the country, health plans and employers look to Papa to provide vital social support by pairing older adults and families with Papa Pals, trained...

Nurse (RN) At ComForCare Home Care we value our nurses like family and invite you to become a part of our team. We celebrate success and have fun! If you are an RN/LPN and have a background in geriatric care management, consider working...

Pickerington OH 43147 Adult, Jtube, Trach Monday-Friday 7a-3p Day Shift Maxim Healthcare Services is seeking a Registered Nurse (RN) to assume responsibility and accountability for the application of the nursing process and the...

Bilingual RN Care Manager (Remote Flexible - Spanish Speaking) At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we...

Patient Care Manager And RN Dual Role Summary: We are hiring a Patient Care Manager and RN Dual role with Home Health experience. At Caretenders Home Health, a part of LHC Group, we embrace a culture of caring, belonging, and trust and...

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach...

Registered Nurse Care Manager As an advocate for the patient, the RN care manager will assess, plan, implement, coordinate, monitor, and evaluate the options and services required to meet an individual's health needs, using clinical and...

A telehealth practice is seeking a Virtual Registered Nurse to provide high-quality patient care through EMR messaging. This role requires a BSN, an active nursing license, and a minimum of 4 years of clinical experience. You will manage direct...

Explore opportunities with Caretenders, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best,...

Telephonic Case Manager 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 solutions...

A healthcare organization is seeking a Care Manager, RN to provide comprehensive care management for members. This role involves engaging members, promoting health behaviors, and coordinating care within a supportive team. Candidates must have at...

ClearSky Health Nursing Opportunities Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients,...

2536 Remote?: 0 Highlights (Bonus, shift, relocation, info for job): Monday through Friday, 8-5 with hour lunch, no weekends, no on-call, with paid holiday time off and paid...

Registered Nurse - House Supervisor Job Type: Full Time Shift: Days 36 hour weeks (7 am - 7:30...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Job Description: Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply...

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...

Join BoldAge PACE and Make a...

A healthcare organization in California is looking for a dedicated Registered Nurse to join their Clinical Care Delivery Team, where you'll provide telemedicine care to seriously ill patients. The ideal candidate will have a deep commitment to...

A leading health organization in Rancho Cucamonga, CA is seeking a dedicated care management professional to join their team. The role involves providing high-quality care to members, ensuring seamless transitions, and collaborating with...

PURPOSE AND SCOPE:Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure quality patient care while maintaining...

A leading healthcare organization in Alexandria, VA is hiring an Integrated Nurse Case Manager for a full-time role. This work-from-home position involves conducting home visits and providing case management for members with complex conditions.