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RN Clinical Manager / Clinical Consultant (RN or MSW) – California Pay Rate: $52.50–$53.00/hr Position Type: Special Projects – 12-Month W2 Contract (renewal based on performance, project continuation, and health plan needs)...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...

Position SummaryThe Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective outcomes...

RN Utilization Mgmt Full-Time Day POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include: the e-TAR process, denials management,...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

Provide care for individuals who have, or will have, a diverting ostomy. Provides wound and skin evaluation and care. This specialized nursing care is given independently...

RN Health and Social Services Care Coordinator $5,000 Sign-on Bonus for External Candidates At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care.

Responsibilities Under the direction and supervision of the Chief Nursing Officer, The Vice President of Nursing Operations leads and manages a national team of RN Case Managers. The primary responsibility of...

Registered Nurse (RN) - Clinical Documentation Specialist (Part Time) Remote The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients'...

Utilization and Care Management Nurse Work from home within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are...

Job ID: 30409 *Description*Become a key member of a world-class health organization. Contribute to the delivery of Magnet® designated nursing excellence. Take your career to the next level. Ucan do all this and more at UCLA Health. ...

Join Us in Shaping the Future of Health Care At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we...

Travel RN Case Manager Assignment length- 13 weeks Near Los Angeles Area Our Client is a nonprofit, independent healthcare organization committed to improving the health status of the...

Job Description The Denials Nurse Auditor works under the supervision of the manager of PFS Denials. The Denials Nurse Auditor is responsible for completing, appealing, tracking, and reporting clinical denial reviews to...

Utilization Review NurseWork Location: Los Angeles, CAJob #: 30315Work Hours: Monday-Friday 8am-4:30pmEmployment Type: 4 – Staff- LimitedDuration: 6 monthsSalary Range: $74.16–107.75 hourlyPosted Date: May 15, 2026Bargaining Unit: CNA –...

OverviewPosition Type: Full timeJob Title: Care Review Clinician ILocation: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle),...

Job Description: Participates in the development and ongoing implementation of QM Work Plan activities. Improve quality products and services, by using measurement and analysis to process, evaluate and make...

Job Title 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.

Description To participate in a remote work arrangement, employees must reside in the United States. No remote work arrangement will be considered for working from outside the United States. Current staff, faculty/adjunct at Herzing...

Blind Childrens Center Inc in Los Angeles seeks a Registered Nurse Consultant to provide pediatric nursing and health training. Responsibilities include conducting health screenings and developing health plans for children.The ideal candidate...

To support healthcare revenue solutions, the full-time Remote Clinical Review Nurse will analyze denied insurance claims, draft persuasive appeal letters, and collaborate with legal teams to optimize patient care revenue without direct patient...

Description: About Us Hines is a nationwide, independent leader in personalized managed health care, focused on what's important to you—comprehensive services with the program excellence and cost containment that you demand. Hines & Associates,...

Clinical Research Registered Nurse (RN) Infusion Registered Nurse (RN) to support the execution of clinical trials in a fast-paced research environment. This role combines direct patient care with clinical research responsibilities,...

Utilization Management Nurse Specialist Company Description Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients...

Overview Expand Access. Lead Markets. Transform Care. We are seeking a RN Executive Director Specialist - Hospice to join our leadership team. This role acts as the administrator on call and is...