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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...

Registered Nurse (2993) Fully Remote • CVBC - Care Management - Irving - Irving, TX 75062 Overview Education Level Associates Degree Category Other Positions Description US Heart and...

Elevance Health is seeking a Nurse Case Manager II to manage complex patient care telephonically or on-site, coordinating plans across the care continuum. The role requires a RN license, BA/BS in a health field, and 5+ years of clinical...

Job Title Case Manager Company Highmark Inc. Job Description This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and...

Chronic Care Manager (RN) Vitability Health of New Jersey Remote Position Our Mission At Vitability Health of New Jersey, we believe great care goes beyond checklists and charts—it's about relationships,...

Elevance Health, Inc. is seeking a Medical Management Nurse to evaluate the most complex cases, using nursing judgment and holistic assessment to determine medical necessity. The role collaborates with providers and Medical Directors to...

CorVel is seeking a Utilization Review Case Manager to gather demographic and clinical data for in-patient and outpatient reviews, certify medical necessity, and assign appropriate LOS while supporting the Case Management department's goals. This...

Job Overview: Pay Range: $46.76hr - $51.76hr Requirement/Must Have: 5+ years Clinical nursing experience. 2+ years Care Management. Bachelor's Degree in Nursing.

A leading Health Insurance company is seeking a talented RN Care Management Coordinator for a remote contract position. The role involves applying critical thinking and medical knowledge to determine case appropriateness and collaborating with...

Insurance Or Managed Care Industry Registered Nurse (RN) $40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically...

Kelsey-Seybold Clinic, part of the Optum family, is seeking an ED RN Case Manager in Pearland, TX. You will monitor ADT notifications and coordinate proactive outreach, discharge planning, and transitions of care with hospital and outpatient...

Granite VNA in New Hampshire is seeking a Clinical Resource Nurse (Triage) to serve as the clinical link between patients and care teams. The role involves triaging calls, coordinating home visits and referrals, and providing education with the...

VIVA HEALTH is seeking an RN Care Manager in Birmingham, AL to evaluate member needs and coordinate care toward optimal wellness. This role involves fieldwork outside the office, with travel within the service area; some work-from-home days are...

Kaiser Permanente seeks an RN case manager to coordinate admissions and discharge planning, ensuring appropriate levels of care and cost-effective resources. You will collaborate with physicians, patients, and families to develop individualized...

Why Brighton PRN/REMOTE*Oregon State RN License Required At Brighton/Suncrest Hospice our goal is to change the expectation of hospice care in your area by providing exceptional care and service to...

Position Type: Full Time Department: Patient Programs Work Location: Canada Work Arrangement: Remote Work Hours: Monday to Friday - 8 hour rotating shifts between 8am - 8pm...

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...

Alignment Health is seeking a compassionate Registered Nurse to serve as a Telephonic Case Manager for SNP members, working remotely from anywhere in the U.S. The role focuses on coordinating care, closing gaps in care, and guiding patients and...

Geisinger is seeking an RN CDI Specialist for a remote, full-time position based in Pennsylvania. You will act as a liaison between clinical and coding functions and educate staff on documentation relevant to Revenue Management and Discharge Not...

ArchWell Health is re-imagining the practice of primary care. We are putting the relationship between patient and physician at the center of a value-based model focused on outstanding patient experience, improved access, and better outcomes. In...

Arkansas Blue Cross Blue Shield is seeking a remote Member Triage Nurse to support the Clinical Services and Population Health division (CSPH). You will assess members for needed resources and coordinate care with CSPH, case management, and other...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

OUR MISSION We exist to create a more connected, compassionate, and confident experience for people with cancer and those who care for them. We make it easier to get answers, access high-quality care quickly, and feel...

Company : Highmark Inc. Job Description : JOB SUMMARY This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider...

Baptist Health is seeking a Revenue Integrity RN to join our team in a remote role requiring residency in KY or IN. You will review payor medical necessity for services, obtain predeterminations and respond to denials or audits to recover revenue...