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Telephonic Case Manager Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has...

Job Requirements Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need...

National Care Advisors seeks a Nurse Case Manager based in Portland to oversee case management for special needs and eldercare, coordinating with families, attorneys, financial planners, and trustees to improve quality of life. The role requires...

Appeals 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 who care...

Sagility LLC is looking for an Associate Manager for US Clinical Operations RN. In this role, you will oversee shift operations, manage a team, and ensure the highest standard of patient care and service delivery. Ideal candidates should...

Job Description RN Hospice Workflow Specialist / Weekend Manager (Remote) Position Summary The RN Hospice Workflow Specialist / Weekend Manager is responsible for overseeing and coordinating hospice clinical operations...

Compliance Nurse 2 - LTC Program - SW Region The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for...

Job Title Employment Type: Full time Shift: Rotating Shift Description: This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint...

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health,...

Saint Luke's Hospital of Kansas City in the United States is seeking an experienced Registered Nurse for our Primary Care Shoal Creek location. The role features a Monday through Friday schedule, 8:00 am to 4:30 pm, with no nights, weekends, or...

Cabell Huntington Hospital is seeking a casual, as needed Virtual Integrated Care Coordinator (RN) for our CHH Virtual Integrated Care Department. This job is responsible for supporting and...

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care...

Case Manager The Case Manager manages an individual caseload using the case management process in order to meet the needs of the MedWatch, LLC customers and consumers. This includes, but is not limited to, authorization of services,...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

Psychiatric Registered Nurse This Psychiatric Registered Nurse position is located at Bradley Hospital in Riverside, RI on the CADD Inpatient Unit. This day position is full-time at 36 hours per week. Utilizing the nursing process,...

Resp & Qualifications We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Inpatient Case Management Service Registered Nurse VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking to hire an experienced Registered Nurse to work in our Inpatient Case Management Service. Incumbent is expected to function...

Case Manager The Case Manager uses InterQual criteria to evaluate the appropriateness of admissions, concurrent stay and readiness for discharge. She/he assures the correct level of care: critical, telemetry, acute, observation, for all...

Immediate need for a talented RN Case Manager. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact...

Job Summary: We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, or Operating Room to perform utilization review duties. The Registered...

Location Designation: Fully Remote Business Unit Overview Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-size and large companies. Our work fosters...

Talkspace is seeking a Part-Time Psychiatric Nurse Practitioner to provide remote psychiatric care to diverse patients via our platform. You'll consult within Wyoming licensure, conduct PDE/E/M sessions, and document treatment plans, while...

Avardis Health Management is seeking a PRN RN Case Manager to lead patient care journeys from a home-based setting, with the flexibility of remote work. You will collaborate with a high-energy team to improve outcomes, access to care, and cost...

UCI Health Utilization Management Position UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a...