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DescriptionJoin a world-class healthcare organization and play a key leadership role in delivering high-quality, patient-centered care. UCLA Health is seeking a dynamic and experienced Utilization Management Assistant Director to oversee Intensive...

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...

Field Nurse Case Manager Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has...

Clinical Documentation Integrity Specialist/Consultant The Clinical Documentation Integrity (CDI) Specialist/Consultant serves as a trusted advisor to client organizations, providing expert guidance in clinical documentation practices...

Patient Support Nurse The Patient Support Nurse will provide support for Oncology patients and caregivers over the phone, by being able to speak to the end-to-end journey for patients in the context of the Oncology program specifics.

Evenings, Weekend Only, Full-time & Part-time opportunities available (20hrs +) Hiring for evenings and weekends (*weekends and holidays are required) Incentives for Bilingual Spanish Telephone Triage RNs! Are you looking for an...

Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our...

Clinical Systems Analyst II, RN - REMOTE Position Type Full Time Job Shift Day Education Level 4 Year Degree Travel Percentage Up to 50% Category Professional Services DSS, Inc. is a leading health information software development...

Temporary Contact Center Navigator UPMC Health Plan and Workpartners is hiring a temporary Contact Center Navigator. This role will work Monday - Friday (Mondays and Friday standard daylight hours EST, Tuesday - Thursday 12 pm - 9 pm EST)...

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.

Job Opportunity Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating...

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,...

Pharmacy Nurse Consultant - LPN or RN If your answer is "all of the above," consider joining our team at Consonus Pharmacy. It's a perfect opportunity for compassionate people dedicated to people's health and well-being. Consonus...

We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone...

To support clinical auditing efforts, the full-time RN Clinical Auditor will perform retrospective chart reviews on Readmission and Place of Service Claims, utilizing clinical guidelines and proprietary systems while maintaining productivity and...

Job Title: Medical Claims Review Nurse Duration: 6 Months Location: Remote Payrate: $43.39/hr. on W2 Description 100% Remote (CANDIDATES MUST LIVE IN ONE OF THE PREFFERED 17 STATES (SC, MS, AZ,...

Community Health Accreditation Partner (CHAP) CHAP has been a trusted, independent, nonprofit accrediting organization dedicated to improving the quality of care delivered in home and community settings since 1965. This is a unique...

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,...

We're growing - join our award winning culture as we serve members in your area! This is a float position primarily within Dodge County, potential travel up to 2 hours within the service region. The RN...

Job Description Summary The RN (Registered Nurse) - Clinical Documentation Specialist I report to their respective Manager, Clinical Documentation. Under general supervision, the RN - Clinical Documentation Specialist I conduct reviews of...

Shift Schedule: Per Diem (Hourly as Needed) false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Position Purpose: The Clinic Nurse will participate as a member of a team providing nursing...

Utilization Management Review Nurse The Utilization Management Review Nurse reviews the medical necessity and appropriateness of healthcare services and treatments through the medical information of individual patients and the limited...

POSITION SUMMARY The RN – Clinical Training Specialist trains new and current team members to support success in the delivery of quality care and services to residents. The RN – Clinical Training Specialist champions the...

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 –...

The Registered Nurse Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care Manager...