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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...

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform both inpatient and outpatient...

Shearwater Health Registered Nurse, Utilization Review At Shearwater Health, we know that better patient outcomes are never achieved alone – especially when there aren't enough hands to deliver care. That's why we've built something...

Location This is a hybrid role. Applicants must be able to commute to or travel to Mitchell and Dougherty counties, GA, when required. About Us The Columbus Organization is a nationally...

Registered Nurses| School Cases | 1 on 1 | Full Time | | Pediatrics | ASAP | 27402 Job Description: Are you a licensed RN with a passion for working with children? Do you want a role with a...

Lake Cumberland Regional Hospital, part of Lifepoint Health, is seeking a Clinical Documentation Specialist RN to join our Somerset, KY team. This hybrid role offers onsite and remote work with day shifts and rotation. You will collaborate...

Alignment Health is seeking an experienced inpatient review nurse to join our remote utilization management team. You will guide patients through the care continuum, collaborate with physicians and case managers, and ensure care is appropriate,...

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...

GQR Healthcare is seeking a LPN / LVN Case Management for a travel job in Los Angeles, California. Job Description & Requirements Specialty: Case Management Discipline: LPN / LVN Start Date:...

Experience 2-5 years needed. Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific...

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 ways you never imagined possible. We know you've honed your career in a fast-moving...

Jobgether, on behalf of a partner organization, seeks an experienced Registered Nurse for a remote Utilization Management role. You will review cases, assess medical necessity, and support prior authorization decisions while collaborating with...

Job Description Remote Prior Authorization LVN/LPN Location: Remote (United States) Type: W2 Contract (Temporary) | Hours: 40/week Pay Rate:...

The Registered Nurse is responsible for overseeing the health, wellness, and psychiatric stability of patients receiving Full-Service Partnership (FSP) and broader outpatient behavioral health services. The position is primarily...

JR0059223 Tele-Health Nurse (Remote/LPN) (Open) Full-time McKesson requires new employees to be fully vaccinated for COVID-19 as defined by the CDC, subject to applicable, verified accommodation requests. McKesson is in...

Cardinal Health is seeking a Nurse, Individualized Care Manager to coordinate patient-centered care, education, and case management across oncology and chronic care. You will collaborate with inpatient and outpatient teams to optimize outcomes for...

Job Summary and Responsibilities As our RN Care Coordinator, you will be a central figure in patient care, seamlessly navigating the healthcare journey to achieve optimal outcomes and an exceptional patient...

Utilization Management Nurse I, RN Huntington Beach Office - Huntington Beach, CA 92647; Arcadia Office - Arcadia, CA 91007 Overview Salary Range $72,758.00 - $89,128.00 Salary/year Position Type Full Time...

Medix is seeking a Remote Telephonic RN Case Manager to provide telephonic case management for chronically ill members within a C-SNP population. The role requires an active Compact State RN license or CA license and a strong commitment to patient...

The Columbus Organization is hiring a Clinical Intake Specialist-LPN to act as the primary contact for individuals with complex care needs. You will conduct initial visits, perform needs assessments, and coordinate care with the Case Manager to...

Explore opportunities with Amedisys, part of the Optum family of businesses. We provide home health, hospice and community-based services that help people receive quality care where they feel most comfortable: at home. Rooted in personalized care,...

Responsible for collaborating with healthcare providers and physicians for problem solving, prioritizing and facilitating patient care objectives, the coordination and...

Medical Management And Health Education Program Coordinator The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers...

Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

Utilization Management Nurse (RN) (Temporary) Remote in California We believe every candidate deserves thoughtful consideration. That's why we do not use AI or automated systems to review applications. Every application is reviewed...