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Nascentia Health is seeking a Remote Care Manager to provide care coordination for health plan members, develop PCSPs, and document care in accordance with plan standards. This role operates Monday–Friday, 8:00 AM–4:30 PM, with a remote-first...

Molina Healthcare is seeking a registered nurse for a 100% remote care management role on our fast-paced auto-dialer team. This position supports coordinated member care across the continuum to achieve desired outcomes and cost-effective care.

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...

Utilization Review Nurse Rising Medical Solutions has an opening for a Utilization Review Nurse, and we want to hear from you! We're a bill review and cost containment company - so what does that mean? Basically we are trying to fix a...

VCU Health is seeking a Nurse Manager for Virtual Monitoring to lead a multidisciplinary remote patient monitoring team, including telesitters, telemetry staff, and virtual nurses. You will ensure high-quality virtual care, optimize workflows, and...

Position: Remote Nurse Consultant Company Overview: Absolute Elder Care is a leading provider of in-home care services for seniors. Our mission is to provide compassionate, personalized care to help seniors maintain their...

Medcor is seeking a Telephonic Registered Nurse for our remote 24/7 Occupational Health triage call center. This full-time RN role focuses on evening ight shifts (8 or 10 hours, 3pm–4am CST variants) with a start date mid-June 2026.

EK Health is hiring a Full-Time Telephonic Nurse Case Manager (RN) to assess, plan, implement, coordinate, and evaluate care options for injured workers. Role supports return-to-work objectives while maintaining cost-effective care, with a remote...

Medix is seeking Board Certified physicians with Health Plan Utilization Management experience for a fully remote role. You will perform physician-level medical necessity determinations across Commercial, Medicare, and Medicaid populations, review...

Category : Customer Service/Support As a Healthcare Customer Support Specialist, you will serve as a primary point of contact for our clients, managing inbound and outbound communications with professional excellence. Utilizing a suite of...

Careforth, Inc. in Ohio seeks an RN Care Manager or LSW/LISW Care Manager to join a collaborative team. You will onboard families, assess needs, guide service activation, conduct home visits, and develop person-centered plans while coaching...

Highmark Health is seeking a Remote Nurse Care Manager to implement utilization management strategies across care settings. The role requires weekend availability (Saturday and Sunday) plus three weekdays, with a focus on reviewing care...

A prominent healthcare company is seeking a Case Management Nurse to conduct comprehensive assessments and develop care plans for beneficiaries. The ideal candidate will have 5+ years of clinical RN experience and a current RN license.

Oversee system-level matrix oversight of utilization management activities. Ensure use of medical necessity criteria (InterQual and/or Milliman). Manage professional staff with at least two years of management experience.

Lehigh Valley Health Networkis seeking an experienced RN to join the Utilization Management team in a remote role. You will review admissions, determine appropriate patient class, and ensure payer-aligned care decisions using evidence-based...

Veterans Health Administration in Leeds, MA seeks a Registered Nurse (Risk Manager/ Quality Management Specialist) to oversee the Enterprise Risk Management Program and integrate risk analysis with the Quality Improvement initiatives. The role...

WebTPA, a GuideWell Company, is seeking a Registered Nurse Case Manager in Irving, TX to create, implement, and monitor treatment plans helping members meet healthcare goals. You will assess health status, coordinate care with providers and...

Umpqua Health in remote Oregon seeks a Care Coordinator to manage care for Medicaid/Medicare members. You will conduct in-home assessments, develop care plans with families and providers, and coordinate services across LTSS, behavioral health, and...

DocGo is hiring a remote nurse to coordinate employee health compliance programs across our AI-powered logistics network in the United States. You will manage OSHA respiratory protection, Hep B, TB screening, and related health initiatives while...

To support a growing team of elite nurses, the remote Compact RN Care Coach will manage a large panel of Medicare patients with chronic conditions, conducting monthly clinical calls to drive outcomes and reduce hospitalizations in a contract...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Quality Community Health Worker - Remote in Nebraska (2378667) Quality Community Health Worker - Remote in Nebraska - 2378667 At...

Employment Type: Full timeShift: 12 Hour Night Shift Description: This is not a remote position The licensed Registered Nurse (RN) plans &...

Vida is seeking a licensed RN or LPN to manage clinical review requests, escalations, and member inquiries in a fully remote care setting. You will analyze medical records, extract relevant clinical information, and drive cases to resolution while...

To support staffing needs for patients, the part-time Ohio Licensed LPN Scheduler will manage clinical support and staffing duties, ensuring accurate order reviews while working remotely after training.Key responsibilitiesAssign and staff all...

We're looking for an RN who has personally owned grievance and appeals cases from intake to final decision letter. Not someone who supported the team, but someone who built the case file, applied the criteria, met the clock and defended the...