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Compliance Nurse Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders,...

Sentara Health is seeking an Integrated Case Manager, RN to support Eastern Shore region members, concentrating on behavioral health, waiver services, and complex care management. This remote role requires Virginia residency with travel 50%–75%...

Utilization Management Nurse Consultant 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 colleagues...

Seasoned Recruitment is seeking a Board-Certified PMHNP-BC contractor to reclaim clinical autonomy through our telehealth network. As a 1099 contractor, you control when and where you work while we handle credentialing, billing, and insurance...

Explore a World of Opportunity with the State of Georgia! We are the force that drives Georgia! Georgia State Government is a large enterprise, composed of various agencies and entities with a common goal to improve the lives of...

RN Inpatient Authorization This work from home position requires that you live and will perform the duties of the position within 60 miles of an HCA Healthcare Hospital. Experience the HCA Healthcare difference where colleagues are...

Sedgwick is recruiting for a US Telecommuter RN Telephonic Case Manager. The role focuses on coordinating medical services, advocating for injured employees, and facilitating recovery and return to work through telephonic case management.

Healthcare Management Solutions, LLC is seeking experienced CHSD Audit reviewers to conduct independent medical record reviews for the STS CHSD program. This remote, part-time role focuses on data accuracy, source verification, and adherence to...

Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding...

ISYS Solutions Inc. is seeking a Telephonic Case Manager - RN (remote) to provide workers' compensation case management from Augusta or surrounding areas. You will coordinate care, communicate with providers, insurers and attorneys, and document...

Registered Nurse - Utilization Management (Remote) - Philadelphia, PA (Remote) - Contract - Mon-Fri, Day Shift Hours - $41.15-$46.15 Per HR Title: Registered Nurse - Utilization Management (Remote) Location:...

Performs an age specific plan of care for a designated group of patients using the nursing process of assessment, diagnosis, outcome identification, planning, implementation and evaluation of patient care. Collaborates with physicians and other...

Community Registered Nurse (RN)Part-TimeJefferson CountyAt Chariton Valley Association (CVA), a proud partner of Center for Human Services, we EMPOWER people with disabilities to achieve their highest level of independence through high-quality,...

Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic...

Firefly Health is seeking a Registered Nurse to join its remote care team supporting patients in Massachusetts. The RN will triage new concerns via the app or phone, coordinate appropriate levels of care with clinicians, and provide...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

Position SummaryThe Case Manager is a Registered Nurse who provides case management, education and outreach services telephonically to Medicare members in the Chronic Case Management Program. This position requires licensure as a Registered Nurse...

Remote Patient Monitoring (RPM) Nurse – Remote Join Our Growing Clinical Team! We are seeking compassionate, detail-oriented Registered Nurses (RNs) or Licensed Practical Nurses (LPNs) to join our Remote Patient Monitoring...

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

American Senior Communities is seeking a Community Nurse Liaison (LPN) to evaluate patients and coordinate with hospital teams for admission to skilled nursing facilities. The role requires weekend hours (Saturday and Sunday 8a–5p) and a remote...

Awarded 'Great Place to Work' ™ Certification Once Again! Behind every award is a story, and ours is written every day by more than 900 dedicated employees and hundreds of compassionate volunteers who walk alongside...

RN Home Infusion This is a MOBILE position. Employee starts from home and travels to patient homes/visit locations. The service area for this role will primarily focus on the Philadelphia area, followed by the surrounding 4 counties,...

Requisition Details GENERAL REQUISITION INFORMATION EEO Statement: UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and...

Renown Health is seeking a Utilization Management RN to apply medical necessity criteria for prospective and concurrent reviews. You will work with an interdisciplinary team to ensure medically necessary, cost-effective care at the appropriate...