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Professional Nursing Care Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people...

Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of...

Harris Health seeks a Nurse Manager to lead the operational management and care delivery for one or more clinics or units. This role oversees human resources, quality, and financial performance within the assigned area.You will work with the...

Nurse, Concurrent Review Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria, including admission reviews, continued stay reviews, transitional care...

Clinical expertise meets analytical precision in a role that directly shapes how patient care is captured, understood, and valued across the health system. As a Clinical Documentation Specialist, you bring a seasoned nursing perspective into a...

Case Manager The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available...

Conduct comprehensive telehealth sleep evaluations and ongoing follow-up visits Diagnose and manage OSA and PAP therapy, insomnia (including BBT; CBT-I a plus), RLS/PLMD, EDS, and other sleep disorders Develop...

Denials Case Manager, RN The 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,...

Job Summary: The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating...

Leading a nationwide Post-Acute Care Utilization Management team, the full-time RN Director of Utilization Management will oversee daily operations, ensure compliance with policies and standards, and drive performance improvements to achieve...

Utilization Management Nurse RIHS Austin Regional Office - Austin, TX 78727 Overview Position Type Full Time Description Primary Responsibilities The Utilization Management Nurse will determine the...

About Wider Circle Wider Circle is a mission-driven healthcare organization on a mission to improve health outcomes for older adults and people with complex health needs. We do this by addressing the social and clinical barriers that get...

OverviewSt. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the hospital...

Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS).

Description Telephonic Nurse Case Manager (1099 Remote - NJ RN License Required) We are currently seeking an experienced Telephonic Nurse Case Manager (RN) to support workers'...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Job Details Telephonic Triage Nurse Case Manager (Remote) 2026-1475 Dallas, TX, USA Medical Case Management Full Time Description Overview Are you looking to make a difference by providing...

Utilization Management Admissions Liaison RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13180 Salary Range:...

Manager, Telephonic Nurse Case Management The Nurse Case Manager serves as the clinical resource within the Risk Management & Safety team, providing telephonic nurse case management to support injured employees through the workers'...

Responsibilities Leads best practice implementation and patient care delivery systems across multiple locations.Delegates investigation and resolution of patient/family concerns regarding care and services.Facilitates physician and healthcare team...

Job Opportunity Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the...

Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah *Please be advised that this role is part of our candidate pool, which allows us to identify and attract...

Workers' Compensation Telephonic Nurse Case Manager The Workers' Compensation Telephonic Nurse Case Manager is responsible for evaluating and expediting appropriate, cost-effective medical treatment of injured employees with the goal of...

Company Overview: Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from...

Utilization Management Nurse Location: Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a difference for patients,...