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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...

Benefits: High Degree of Independence Flexible schedule Elevate Patient Care from the Comfort of Home Are you a highly skilled RN looking for the autonomy of independent practice and the flexibility of a part-time...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* Job Summary: Reviews all medical (and other) documentation in claim files to answer the specific...

Join our team at Briarcrest Nursing Center, a 135-bed facility! 5648 Gotham St, Bell Gardens, CA 90201 Prioritizing AM and PM shift hires! CNA Lic# must be verified on CDPH.gov (all CNA positions have a CNA license...

To support the Population Health and Health Services area, the full-time Louisiana Licensed Care Coordination Nurse will assess, plan, implement, monitor, and evaluate healthcare services for members, ensuring quality and cost-effective outcomes...

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...

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...

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...

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...

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...

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...

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.

Job Description Nestled between Burbank and Pasadena, Adventist Health Glendale is one of the area's leading healthcare providers. We are comprised of a 515-bed hospital, two urgent cares, home care services, comprehensive...

Field Nurse Case Manager - Glendale, CA Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose. Every...

Vitability Health of New Jersey is seeking an experienced Chronic Care Manager (RN) to provide comprehensive, patient-centered care remotely. You will build durable relationships with patients, manage chronic conditions, and guide them through...

Summary The Remote Patient Monitoring Home Telehealth Case Manager delivers fundamental knowledge-based care to assigned clients while developing technical skills. Assesses, plans, implements, and evaluates care based on age-specific components.

Under the supervision of the RN Patient Scheduler Manager, provides timely, efficient, and accurate triage response and documentation. Evaluates patient needs and performs triage within the contact center setting, operating within...

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...

Aetna is seeking an RN Case Manager located in Charlottesville, Virginia. This role involves utilizing advanced clinical judgment to facilitate healthcare and social services for members, performing assessments, and providing crisis intervention.

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

Maine Community Health Options is seeking a Clinical Specialist who provides clinical decision-making support and coordinates community resources to support medical management. This role analyzes documentation for medical necessity, collaborates...

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...

Med Surg Registered Nurse (RN) Setting: Healthcare Facilities Job Type: Travel Pay: $2606 / Week Hours: 36.00...