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A healthcare company seeks a Remote Utility Management Nurse to optimize insurance coding practices and enhance revenue management. This part-time role offers flexible hours and compensation ranging from $45 to $75 per hour, depending on...

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...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

Innovative Systems Group is seeking qualified healthcare professionals to conduct medical management and health education for customers on government programs. The role includes data gathering for regulatory reports and performing assessments,...

Registered Nurse-Remote Patient Monitoring Home Telehealth Case Manager Department: Department of Veterans Affairs The Remote Patient Monitoring Home Telehealth Case Manager delivers fundamental knowledge-based...

Position Title: Remote Telephonic RN Case Manager Mandatory Requirement: Must hold an Active Compact RN License and/or an Active California (CA) RN License to be considered. Pay Rate: $48.00 – $50.00 per hour...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to...

Telephonic Insurance Case Manager (RN) | ARIZONA RESIDENTS ONLY Insight Global is seeking a Telephonic Insurance Case Manager (RN) to join a growing and well-established organization focused on helping injured employees navigate their...

Job Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members. Providence caregivers are not...

Humana seeks a Utilization Management Registered Nurse to interpret and support medical services coordination, documentation, and benefit determinations. You will work remotely, reporting to the Manager of Utilization Management as part of the One...

CEI is seeking an RN/Managed Care Coordinator in Columbia, SC. The role trains onsite for 4 weeks, then remote work is possible under a hybrid model. W2 contracting with pay of $34/hour plus optional benefits. Responsibilities include...

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...

Elevance Health is seeking an experienced nurse to review complex cases for medical necessity, applying clinical guidelines and nursing judgment. The role involves collaboration with physicians, case managers, and Medical Directors to optimize...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

Sentara Health is looking to hire a Remote Integrated Case Manager. Candidates must reside in the State of Virgina. The Integrated Case Manager is responsible for case management services within the scope of licensure;...

SHIFT: Any (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will...

SCAN Health Plan is seeking a Medical Management Specialist-RN (Temp) in Long Beach, CA. The role focuses on promoting appropriate inpatient and outpatient care, applying criteria, and coordinating complex cases within regulatory timelines.

UnitedHealth Group in Las Vegas, NV is seeking an RN Case Manager Telephone Advice Nurse to join the team. This remote, full-time role supports telephonic patient care and education, with a daytime schedule and Nevada residency requirement.

OPCO Skilled Management is seeking a Central Intake Nurse for a remote, full-time role. You will collect referral documentation from physicians, insurers, and providers to determine service appropriateness and coordinate patient care plans with...

RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued stays, and services, while coordinating with providers and payers to ensure compliance with...

Case Management Utilization RNPrimary Location: Panorama City, California Facility Name: Panorama City Medical Offices 4 Employee Status: Regular Schedule: Part-time Scheduled Weekly Hours: 32 Shift: Day Salary: $68.95 - $84.38 / hour Job Number:...

CareHarmony's Care Coordinators (LPN) (NLC) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced Licensed Practical Nurse – LPN Nurse (LPN)...

Brighton Health Plan Solutions, LLC is seeking an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely in North Carolina. You will use evidence-based guidelines and internal criteria to determine...

Southern Illinois Healthcare is seeking a Registered Nurse or LPN licensed in Illinois to join our Population Health team in a fully remote capacity. The role emphasizes patient advocacy, care coordination, and coaching patients toward...

Registered Nurse - Utilization Management (Remote) - Philadelphia, PA (Remote) - Contract - Mon-Fri, Day Shift Hours - $41.15-$46.15 Per HR Title: Registered Nurse - Utilization Management (Remote) Location:...