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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...

Registered Nurse II Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Nights Job Description Join a team that's shaping...

The Veterans Health Administration is seeking a Registered Nurse (Case Manager/Care Coordinator) at the Charleston VA Medical Center in the Nursing, Specialty department. The role focuses on complex patient management, discharge planning, 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)...

Registered Nurse Clinical Annotator Location: Remote Job Type: Full-time Experience Level: Mid-Senior Level Department: Clinical Operations Pay Rate: $37-$39/hr ...

UnitedHealth Group is seeking a Telephonic RN Case Manager to act as the primary contact for members with complex medical and social needs. You will conduct telephonic assessments, create person‑centered care plans, and coordinate services...

Job Description Hours are as needed, Monday - Friday during business hours; you will work 4, 8 or 10-hour shifts as needed to fill gaps in staffing. Hours can also include weekends but not required. This position is remote.

To assist injured workers in receiving timely and appropriate medical care, the full-time Remote RN Telephonic Case Manager will assess, plan, implement, and coordinate care while working Monday through Friday from 8:30 am to 5:30 pm local...

Telephonic Case Manager (RN) Immediate need for a talented Telephonic Case Manager (RN). This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact...

Compassus is seeking a Hospice RN Clinical Coordinator to oversee administrative and management functions in the absence of the Director of Clinical Services. May carry caseload and ensure compliance with state and federal regulations. Remote role...

Renown Health is seeking a Utilization Management RN to apply medical necessity criteria for prospective and concurrent reviews. You will work with an interdisciplinary team to ensure medically necessary, cost-effective care at the appropriate...

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...

Current Saint Francis Employees - Please click HERE to login and apply. Full Time Shift: 10a - 10p Minimum of 5 years bedside experience preferred. Critical Care RN experience required...

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...

Salary: $70,779.53 - $77,857.48 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2026-00669 Division: Healthcare Facility...

Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic...

Sedgwick is recruiting for a US Telecommuter RN Telephonic Case Manager. The role focuses on coordinating medical services, advocating for injured employees, and facilitating recovery and return to work through telephonic case management.

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...

Ardent Health is seeking a Patient Safety Manager to coordinate safety initiatives across its PSO. The role requires analyzing safety events, leading just culture, and disseminating best practices throughout the organization. The manager...

Remote, USA Remote, GA Remote, MS Remote, NC Remote, TN Remote, AR Remote, TX Remote, KY Remote, AL Remote, IN Full time R260000007037 Compensation for this role is...

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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...

Nurse Care Manager - Telephonic (Local Remote) Tandigm Health, a transformational leader in population health management, is looking for a Nurse Care Manager - Telephonic in the greater Philadelphia area. We offer a competitive...

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...

Utilization Management RN (Illinois) Position Type Full-Time Job Shift Day Education Level Bachelor's Degree Category Nursing Professional & Support Centurion is proud to be the provider of comprehensive services to the Illinois...