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RN Utilization Management Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care...

Position: #710299 Program: Case Management Department: Health Services Reports to: Manager, Nurse Case Management (LVN) Shift Differential Premium: Additional $1.75 per hour for hours worked between 6pm-6am...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

Business Area Manager (Nursing) Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that...

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

Care Navigator Position Position at Healthmap Solutions Company Background Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations.

Employment Type: Full time Shift: Day Shift Description: Purpose Work Remote Positon The Nursing Support (NS) colleague (uncertified,...

The Supportive Housing Case Manager (Ages 18–25) supports young adults in securing and keeping stable housing while building life skills and independence. Using a positive, youth-centered approach, you'll carry a small caseload (12–18...

A healthcare organization in Culver City is seeking a qualified Registered Nurse to conduct comprehensive assessments, develop individualized care plans, and deliver skilled patient care. The ideal candidate will possess a nursing degree, a valid...

The Supportive Housing Case Manager (Ages 18–25) supports young adults in securing and keeping stable housing while building life skills and independence. Using a positive, youth-centered approach, you'll carry a small caseload (12–18...

Prior Authorization Nurse Case Manager (PACM) The role of the Prior Authorization Nurse Case Manager (PACM) is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of...

The Case Manager is responsible for utilization review and case management activities within the hospital. This position involves performing chart reviews, quality assessments, and ensuring appropriate patient discharges while adhering to the...

Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Registered Nurse (RN) – Home Health (In-Office) Location: Covina, CA Job Type: Full-Time Schedule: Monday–Friday | 8:30...

Clever Care Health Plan is looking for a dedicated Case Manager II – RN in California to manage a caseload of members with complex health needs. You will develop care plans, monitor progress, and lead interdisciplinary teams to improve care...

The nation's leading administrator of long term care insurance services is looking for YOU. This is your opportunity to join a company with a culture that promotes respect for people, integrity, learning and initiative.

Bestica is seeking a travel nurse RN Case Management for a travel nursing job in Marina del Rey, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date:...

Care Coordinator, LPN Remote Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with...

MUST BE ABLE TO WORK AT UF LEESBURG HOSPITAL FOR 3 DAYS- IN HOUSE ROUNDING AND SEEING PATINETS PER MED STAFF MUST HAVE ONE-YEAR HOSITALIST EXPERIENCE, AS MED STAFF REQUIRES IN PATIENT CASE LOGS-THIS IS NECESSARY TO GET...

Job Description Job Title: Senior LTSS Care Manager (RN) Location: Remote, Texas (Candidate should be from Austin area) Duration:...

Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $142,166.00 (Max.) Established in...

We are seeking a compassionate nurse (LPN) to join our growing team! In this role, you will provide critical after-hours support, triaging hospice patients and family needs over the phone wit professionalism and empathy. You will help ensure...

AHMC HealthCare is seeking a Case Manager RN or LVN for the Utilization Review Department at Monterey Park Hospital, a 101-acute care facility in Whittier, California. This per-diem position involves coordinating care for adult and pediatric...

Job Description The Medicare Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post service or claim denial. The Medicare Appeals and Grievances...

CHA Hollywood Presbyterian Medical Center CHA Hollywood Presbyterian Medical Center (HPMC) is an acute care facility that has been caring for the Hollywood community and surrounding areas since 1924. The hospital is committed to serving...

Your Role The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans,...