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Description: Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient...

Working remotely in a full-time capacity, the Registered Nurse Utilization Management will manage complex reviews and processing of authorization requests for various medical services, ensuring compliance with regulatory standards while...

Details Client Name Dignity Health California Hospital Medical Center Job Type Travel Offering Nursing Profession Nursing...

Case Manager, RNNorth Hollywood, CA, USAWelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. We serve the most vulnerable seniors with better quality and...

Job Title: Remote Prior Authorization Registered NurseJob Description We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid) populations. In...

About This Role The Case Manager Utilization RN-Per Diem works collaboratively with physicians to coordinate admissions and continued stays, ensuring appropriate care levels for patients. This role is ideal for experienced nurses who excel in a...

Expedite Healthcare Solutions is seeking a local contract nurse RN Case Manager, Acute Care Case Management for a local contract nursing job in West Hollywood, California. Job Description & Requirements Specialty: Acute Care Case Management...

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...

Position Summary:We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with...

Description RN - Quality Assurance located at Providence Willamette Falls Medical Center (primary location) and Providence Milwaukie Hospital (secondary location), with rare travel to Providence Newberg Medical Center. The position does not...

Sedgwick is seeking an RN Telephonic Case Manager to join our US telecommuter team. You will partner with injured workers, employers, and providers to design a case management strategy that promotes medical recovery and a successful return to work...

ATC Candidate Medical Clearance Coordinator Serves as a member of a multidisciplinary team to provide assessment, planning, implementation, coordination, evaluation and monitoring of ATC Candidates throughout the medical clearance...

Athens Administrators is seeking a Telephonic Nurse Case Manager to support our Managed Care Department. This full-time role is remote and can be located from multiple states; it operates 9am–5pm Pacific Time, Monday–Friday.

Job Description: The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing...

Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a...

UnitedHealth Group is seeking a Transitional Care Nurse Liaison to educate and support high-risk patients during transitions from acute care. You will work with Boulder Community Health and partners to reduce readmissions through patient...

Hospice Registered Nurse Case Manager Location: Central LA (need to be willing to commute) Lead with Compassion & Excellence in Hospice Care Are you an experienced Hospice RN who thrives in leadership and is passionate about...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Overview TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety...

ISYS Case Management is seeking a Telephonic Case Manager (RN, RN-BC) to operate remotely from Tampa or surrounding areas. You will provide telephonic case management for injured workers, coordinating care with providers, carriers, employers and...

Utilization Management (UM) Claims Review Nurse RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide...

RN Care Manager *F/T Variable* Santa Monica, California Full Time RN Care Manager with our Care Management Team at our Cedars-Sinai Tarzana Medical Center in Tarzana, CA. This is a full-time...

Parenteral Services Clinical RN Specialist The Parenteral Services Clinical RN Specialist provides clinical support to the Parenteral Services team through advanced nursing expertise, education, care coordination, and operational...

Devoted Health Services, Inc. is seeking an experienced registered nurse to perform comprehensive clinical reviews across pre-service, concurrent, and post-service cases within a fast-paced Utilization Management environment. You will...

1 day ago Be among the first 25 applicants 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...