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Piper Companies is seeking an Episodic Care Manager for a fully remote opportunity within the healthcare and managed care industry. This Episodic Care Manager position is a long-term contract role responsible for conducting utilization...

Position Summary Monitors the admissions, continued stay, and discharge of patients following pre-established criteria. Assures that patients meet MCG criteria from admission to discharge including appropriateness of level of care. Conducts...

Overview Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the...

Job Summary and Responsibilities As our RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these services. The RN Care Coordinator performs this...

SafeGuard Services (SGS), a Peraton subsidiary, seeks a Nurse Reviewer Team Lead to guide medical reviews and fraud investigations within the SGS team. You will oversee workload, mentor staff, and coordinate with investigations to develop cases...

Guidehealth is seeking a remote-based Care Manager (RN) to guide patients and families through complex health journeys. You will blend clinical expertise with holistic care, addressing medical, behavioral, and social needs while coordinating...

Ansible Government Solutions, LLC is recruiting multiple Remote Registered Nurse Case Managers to support the VA Office of Veterans Community Care. The role involves managing SEOC data, ensuring compliance, and reviewing provider and veteran...

A health care organization in Monterey Park is seeking a Case Manager (LVN or RN) to manage patient care effectively. This role involves working collaboratively with medical teams to establish discharge plans and ensure compliance with health...

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage of life.

Team Manager The Team Manager is the leader of the Patient Care Team that ensures that patients and families receive continuity and quality of care from admission to discharge or transfer to bereavement. Salary Range: $130,000- 140,000/...

Clinical Operations Nurse Coordinator RN II The Clinical Operations Nurse Coordinator RN II reports to the Manager of Clinical Operations. The Clinical Operations Nurse Coordinator RN II will work independently and collaboratively with...

Job Description Utilization Review RN - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA...

Sedgwick is seeking an RN Telephonic Case Manager to support injured workers nationwide. This full-time role blends clinical assessment, advocacy and collaborative coordination with employers, providers and claims teams. A compact license...

This is a work from home position paying $26-$28/hr Job Description The Clinical Quality Assurance Coordinator is responsible for ensuring case reports are of the highest quality and integrity and in full compliance with client...

Support, Inc. is seeking a Nursing Coordinator/Registered Nurse to oversee medical care for individuals with intellectual and developmental disabilities. You will coordinate with physicians and interdisciplinary teams to promote health...

Research Nurse (Per Diem) - Greater Portland, OR areaIllingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device industries. These include mobile research...

PIH Health Downey Hospital is seeking an RN Case Manager to guide patients from pre-admission through post-discharge, ensuring smooth transitions and appropriate utilization of hospital services.You will focus on maximizing reimbursement from...

About the Role Mercor is hiring experienced Nurse Practitioners to help evaluate and improve cutting-edge AI systems. In this role, you'll evaluate AI-generated clinical content and workflows, leveraging your real-world expertise...

Nurse Case Manager Position Type: Full-Time Contract Role Location: Work from home Work Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive) Schedule: Mon-Fri 8am-5pm EST...

Case Manager RNTorrance, CA, United StatesSalary - $51.44 to $64.87 (US Dollar)Job Summary:Salary - $51.44 to $64.87Experience: Requires Case Management (Care Coordination or Utilization Management) in acute care.Job Location: Torracne, CAJob...

Denials Case Manager, RNThe 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, maximize accurate...

Enlyte is seeking a Field Case Manager (RN) in the El Monte, CA area. This full‑time, hybrid role involves coordinating treatment plans with doctors, employers, and patients to restore function and return to work after injuries or auto...

Registered Nurse – Virtual Care (Part-Time Remote) United States Job Title: Registered Nurse – Virtual Care (Remote) Location: 100% Remote - United States Employment Type:Part-Time W2...