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Location: Orion Building - 6630 Orion Drive Fort Myers FL 33912 Department: Utilization Management - Corporate Work Type: Full Time Shift: Shift 1/7:00:00 AM to 3:30:00 PM Minimum to...

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...

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...

Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

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...

Actalent is seeking an LVN/LPN-certified Nurse Consultant for a fully remote role in the United States. You will conduct 50-70 daily calls with patients/caregivers, ensure therapy initiation and adherence, and address issues such as misdosing or...

CorVel Corporation is seeking a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals. This remote role supports quality treatment and timely return to work,...

LVN Locations: Los Angeles, California Job Category: Nursing Support Position Type: Full-Time Shift: Days Job Description Join a team that's shaping the future of...

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...

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...

A leading healthcare company is seeking a Tele-Health Nurse to provide high-quality service for specialty prescription drugs. This role includes case management and patient coordination. Ideal candidates should possess a Vocational or technical...

Sedgwick is seeking a Telecommuter Nurse Case Manager to join our remote team. You will partner with injured workers, employers, and providers to develop a recovery and return-to-work strategy, coordinating medical services and advocating for...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Part Time Southborough, MA, US Salary Range: $38.00 To $40.00...

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...

The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...

Manage CMS and State Administering Agency audits for PACE compliance.Ensure audit readiness and serve as point with audit teams.Champion compliance culture across the organization.Key Responsibilities:Monitor audit universe data and review...

Psychiatric / Behavioral Health Nurse Job Overview As a Psychiatric / Behavioral Health Nurse, you will help provide comprehensive mental health care for Soldiers, their families, and military retirees. You will also care for those in emotional...

Float Health is seeking an Intake Specialist to manage new patient referrals and coordinate start-of-care visits. This externally facing role requires quick action, clear communication, and meticulous attention to detail to ensure timely,...

Opco-Skilled-Management- is seeking a Central Intake Nurse to coordinate initial and ongoing referral documentation from physicians, insurers, and providers to determine service appropriateness and facility placement. You will develop patient care...

Join UnitedHealthcareAt UnitedHealthcare, we are 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...

Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...

Cottingham & Butler Claims Services (CBCS) seeks a Work Comp Nurse Case Manager for a 100% telephonic role, residency required in IA, IL, or WI. Monday–Friday, no nights, weekends, or holidays, with comprehensive benefits and career growth.

A dedicated medical practice is seeking an experienced Remote LPN/LVN to support patients in Chronic Care Management and Remote Patient Monitoring programs. The role includes conducting phone consultations, documenting findings, and ensuring...

Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals within a NCQA-compliant UM program for DMEPOS. The role collaborates with our Medical Director to assess benefit and medical...

Firefly Health is seeking a Registered Nurse to join its remote care team supporting patients in Massachusetts. The RN will triage new concerns via the app or phone, coordinate appropriate levels of care with clinicians, and provide...