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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...

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 purpose, hold...

Case Management Utilization Management Great care starts with great people. (Like you.) At HonorHealth, you'll find something special. From humble beginnings in 1927 to one of Arizona's largest nonprofit healthcare systems, our...

Join Gainwell It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career...

Hiring for all shifts: Day Shift, Mid-Day Shift, & Nocturnist shifts available| Fully RemoteTX license required and/or IMLC LOQ preferredConsult-Liaison Psychiatry Role | 2+ years of consult-liaison experience post-residency required.Are you a...

Leading a team of clinical professional investigators, the remote Nurse Manager, Pre-Pay Claims will manage day-to-day operations, oversee auditing of medical records, and ensure timely decision-making on claims while driving process improvements...

Optum Home & Community Care , part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical,...

Job Description Remote Prior Authorization LVN/LPN Location: Remote (United States) Type: W2 Contract (Temporary) | Hours: 40/week Pay Rate:...

Come care with us at West Coast University! As a Nursing Academic Specialist for a certified Great Place to Work, you will guide nursing students to do more than change their own lives – you will help change the lives of...

Registered Nurse (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

Host Healthcare is seeking a local contract nurse RN Case Management for a local contract nursing job in Paramount, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 11/02/2026 Duration: 13 weeks 40...

Utilization Review Nurse (LVN) Because health is personal. That's why Personify Health created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care...

WORK REMOTELY after training! CANDIDATE MUST RESIDE IN THE METROPOLITAN NEW YORK AREA! !! Process all requests for services in accordance with Medicare and NYS Medicaid guidelines as well as departmental criteria and...

Detroit Medical Center is seeking a Registered Nurse (RN) Med Surg for a nursing job in Detroit, Michigan. Job Description & Requirements Specialty: Med Surg Discipline: RN Duration: Ongoing Employment Type: Staff Join our dedicated healthcare...

GQR Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Case...

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 does not meet the medical...

Nursing Scheduler / Payroll clerk THIS POSITION IS ON SITE ONLY NO REMOTE WORK Summary/Objective The Human Resources Assistant supports the Human Resources Manager by completing payroll processing , performing clerical tasks , and carrying out...

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...

Case Manager LVN Days Join our team in Los Angeles, CA, as a Case Manager LVN, focusing on patient care coordination and discharge planning. Position Details: Contract: 13 weeks, 40 hours/week, 9am-5:30pm, includes...

Part-Time Nurse Second Baptist School University-Model® (SBSUM) is currently seeking a Part-Time Nurse for the 2026-2027 school year. This role serves in a variety of capacities including UM campus support and administrative support.

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

Wound Care LVN - Regional Travel Skilled Wound Care | Los Angeles, CA + Extensive Regional Travel | Full-Time | $75,000 - 90,000 + Quarterly Bonus...

Telephonic Nurse Case Manager II Location - California - Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and...

Pain Management Nurse (Home Health) – Enhancing Comfort & Quality of Life for Seniors All Seniors Foundation is dedicated to improving comfort and quality of life for elderly patients. Effective pain management is a cornerstone of our...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Patient...