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Utilization Review Nurse- Remote job at Gainwell Technologies LLC. North Carolina. 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...

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...

Curana Health, Inc. is seeking a Utilization Management Nurse for a primarily remote telephonic role focused on review and prior authorizations, concurrent and retrospective care reviews, and transition planning across hospitals and skilled...

Highmark Inc. is seeking a full-time remote RN Care Manager with weekend availability. The role emphasizes utilization management, applying criteria to ensure appropriate care, and identifying opportunities for Health Coaching and case management.

Hi. We're Hummingbird. We're elevating patient access so patients can get healthcare how, when, and where they need it. We partner with healthcare systems to transform how patients access care, enabling their providers to focus on...

Centene is seeking a Clinical Review Nurse for a remote role in Illinois. The position focuses on concurrent reviews to assess care needs, utilization management, and discharge planning, leveraging experience in acute care to ensure high-quality...

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...

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the...

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...

Behavioral Health Utilization Management Clinician We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate...

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 Nurse Practitioner – Family & Acute Care (New Grads Welcome) Join to apply for the Remote Nurse Practitioner – Family & Acute Care (New Grads Welcome) role at NPHire This range is provided by NPHire. Your...

CNA is seeking a Telephonic Nurse Case Manager to provide medical and disability case management within the Workers' Compensation claims department. The role involves assessing injured worker needs, coordinating medical evidence, and collaborating...

Now Hiring: Certified Nursing Assistants(CNA) Come Join the team everyone is talking about!!! #CNA Leisure Vale Assisted Living is a pillar in assisted living in Glendale, CA. We approach every day with one goal: To improve the lives...

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...

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...

Highmark Inc. is seeking a full-time remote RN for utilization management. The role requires weekend availability (Saturday and Sunday) and three weekdays, focusing on review of care services, applying criteria, referrals to health coaching, and...

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.

Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal...

Cambia Health Solutions, Inc. is seeking a Care Management Clinician to work from home in Idaho, Oregon, Utah and Washington. You will provide clinical care management, care coordination and utilization management to support members' health...

Kaiser Permanente in Downey, CA seeks an experienced Registered Nurse for case management and discharge planning. You will coordinate admissions and post-hospital care with physicians, patients, and families to ensure safe, cost-effective plans.

GlobalHealth is seeking an experienced RN Case Manager to oversee telephonic case management and advocate for members' health needs. You will coordinate care with providers, educate members and caregivers, and participate in SNP MOC activities...

Telehealth Nurse Practitioner (APRN) for our Skilled Nursing and Post-Acute Facilities - Remote, covering Kentucky, West Virginia, and Ohio Compensation: $105,000 - $125,000 Annual Salary Benefits: Medical, dental, vision, life...

LPNAbout the PositionSpecialty: Licensed Practical Nurse (LPN) Experience: Minimum 1 year of recent experience required License: Active LPN license in the state of practice Certifications: BLS – AHA required; all certifications must be submitted...

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...