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Job ID: Posted: Location: Charlotte, North Carolina, United States Salary: $134,600 - $230,800/year Job Area: Business Operations Company: UnitedHealth Group...

Sentara Health Plans is seeking a Care Coordinator- LPN to provide case management for Members in Nursing Facilities across Roanoke, Lynchburg and Danville areas. The role is remote from home with periodic travel to facilities; typical hours are...

UCLA Health Advanced Practice Nursing Position Work Location: Los Angeles, CA, USA Work Schedule 4-day 10-hour shifts, 7:00am-5:30pm; may include weekends and holidays Salary Range: $68.81 - 88.99 Hourly Employment...

Logan Health Medical Center is seeking a Utilization Management Specialist to review admissions across the system and determine appropriate status. This role suits an RN or Social Worker with acute care experience, capable of collaborating with...

Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah Preference will be given to current employees and candidates who reside in Idaho and Utah* Build a career with purpose.

Centene Corporation seeks an experienced RN to analyze prior authorization requests from a remote location within the United States. The role evaluates medical necessity and appropriate level of care in line with national standards and contract...

Cambia Health Solutions, Inc. is seeking an Utilization Management Nurse to perform prospective, concurrent, and retrospective reviews for member care across multiple states. The role emphasizes applying clinical criteria, ensuring medical...

CEI is seeking a Back RN/Managed Care Coordinator in Columbia, South Carolina. The role is hybrid with onsite work for the first 4–6 weeks, then remote. You must hold an active, unrestricted SC RN license and have experience in Critical...

Seasoned Recruitment is seeking licensed Psychiatric-Mental Health Nurse Practitioners (PMHNPs) to perform online clinical assessments and direct psychotropic medication management. Enjoy autonomy over your schedule and strong administrative...

Conviva Care Solutions is seeking a Telephonic Registered Nurse Care Manager to coordinate patient transitions, guide post-acute care options, and support admissions from a remote setting. You will work with clinical teams to ensure timely...

Sedgwick is hiring a Telephonic Case Manager for a US-based, remote role. The position focuses on partnering with injured workers, employers, and medical providers to create case management strategies that facilitate recovery and a successful...

A healthcare solutions company is seeking a remote Case Management Nurse to lead a multidisciplinary team providing holistic care. The role requires a compact RN license and offers a pay range of $37.00/hr - $39.00/hr. Candidates should have 3...

A healthcare management firm is seeking an RN Care Management Coordinator – Compliance Specialist to ensure compliance with relevant regulations and standards. This remote position requires a minimum of five years of clinical experience, an...

Remote Care Manager (RN) - MUST LIVE IN TEXAS TX, United States Trending Job Description JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state.

WellSky is seeking a registered nurse to conduct telephonic patient evaluations for multiple payer programs, working on Pacific Time hours. The role emphasizes remote care coordination, schedule management, and collaborative protocol development.

Clinical Review Nurse - Concurrent Review TX All On-site Share on Job Description Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday – Saturday 8am-5pm CST- schedule is firm- no flexibility...

Highmark Health is hiring for a full-time remote care management professional. The role requires weekend availability (Sat/Sun) and three weekdays, focusing on utilization management, quality improvement, and proactive member support. The...

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIES: -Assess patient health problems over the phone and via secure video -Schedule appointments and refer patients -Advise and monitor...

Schedule: Flexible Shifts! You provide your manager with the days and start/end time you are available to complete your hours. All United States time zones are welcome. PRN opportunity to work 20-30hrs per week Job Location Type:...

SCAN seeks a registered nurse to enhance frail seniors' ability to age in place by delivering person-centered care telephonically. You will develop plans of care and educate members to manage chronic conditions, reducing hospital visits and...

Community Health Systems, Inc. is seeking a PRN Remote Clinical Utilization Review Specialist to evaluate medical necessity and efficiency of hospital services. You will support denials, appeals, and collaborate with providers to optimize...

Bring clinical insight, nursing expertise, and data-driven precision to a Hybrid/Remote Clinical Documentation Improvement Nurse Specialist career that combines meaningful patient impact, supportive leadership, modern healthcare technology,...

Netsmart Technologies, Inc. is seeking a Registered Nurse with utilization management experience to review ED admissions and apply InterQual/MCG criteria for medical necessity. You will discuss documentation with ED physicians and ensure proper...

Job Summary This position is responsible for ensuring compliance with Utilization Management (UM) and Quality Review (QR) functions performed by the health plan. The role supports clinical review activities requiring 5+ years of experience...

Dimensional Health Care Associates, Inc. (DHCA) seeks an RN Case Manager/Delegating Nurse in Bowie, MD to manage client care and delegate tasks. The role includes travel to client homes, initial and periodic assessments, and coordination with...