• Oncology Prior Authorization Case

    University of Miami (Miami, FL)
    …Operations has an exciting opportunity for a full time Utilization Review Case Manager to work to work remote . The incumbent conducts initial, concurrent and ... retrospective chart reviews for clinical utilization and authorization. The Utilization Review Case Manager coordinates with the healthcare team for optimal and… more
    University of Miami (08/21/25)
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  • Medical Case Manager -…

    Highmark Health (Charleston, WV)
    …**Required** + Licensed Social Worker (LSW)-Non-Specific - State **(OR)** Registered Nurse - Non-Specific **(OR)** Licensed Professional Counselor ... with external contacts. + Communicate effectively while interacting with Case Management Specialists, Management Team, Physician Advisors and other interdepartmental… more
    Highmark Health (08/14/25)
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  • Remote RN Admissions Case

    Ochsner Health (New Orleans, LA)
    …Contents are subject to change at the company's discretion. **Education** Required - Registered nurse diploma. Preferred - Associate's degree in nursing. **Work ... in case management or utilization review. **Certifications** Required - Current Registered Nurse license in state of practice. Preferred - Commission for… more
    Ochsner Health (07/30/25)
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  • Pediatric Case Manager

    CVS Health (Montpelier, VT)
    …social challenges. We're uniquely positioned to meaningfully improve health outcomes and costs. As Case Manager RN , you will be responsible for assessing, ... will not satisfy this requirement)** **This is a full-time, remote , telehealth role. Must live in a compact state...the client and the member's provider. **Required Qualifications** + Registered Nurse that must reside in the… more
    CVS Health (08/30/25)
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  • Case Manager , Registered

    CVS Health (Jefferson City, MO)
    …And we do it all with heart, each and every day. **Job Summary** The Care Manager - Registered Nurse is a key member of our Special Needs Plan (SNP) ... Meets regulatory requirements within specified timelines. + The Care Manager RN supports other members of the...skills. **Required Qualifications** + Must have active and unrestricted Registered Nurse ( RN ) licensure in… more
    CVS Health (08/30/25)
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  • Case Manager , Registered

    CVS Health (Juneau, AK)
    …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...Maternity/ Obstetrics experience . **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse more
    CVS Health (08/15/25)
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  • Case Manager Registered

    CVS Health (Lansing, MI)
    …status and health needs based on key questions and conversation. **Required Qualifications** **- Registered Nurse with active MI state license in good standing** ... discharge planning and/or home health care coordination experience preferred -Certified Case Manager preferred **Education** -Associates required, BSN preferred… more
    CVS Health (08/27/25)
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  • Complex Case Manager RN - GI…

    Highmark Health (Concord, NH)
    …the appropriate clinical interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are enrolled in case ... management. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing...in addressing targeted populations **LICENSES AND CERTIFICATIONS** **Required** + RN license in PA or WV or DE or… more
    Highmark Health (08/27/25)
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  • Case Manager Registered

    CVS Health (East Orange, NJ)
    …50 to 75% travel in Bergen County and surrounding counties. **Position Summary** This is a remote Case Manager opportunity with 50 to 75% field travel in ... writing and communication skills are required. **Fundamental Components/Job Description:** The Case Manager is responsible for conducting face to face… more
    CVS Health (07/18/25)
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  • Registered Nurse Case

    CVS Health (Totowa, NJ)
    …active New Jersey Choice Certification = $10,000_** + **_External Hire = $7500_** **Position Summary: Case Manager Registered Nurse - Field in Passaic ... County, NJ** This is a remote Case Manager role with...in the role. **Required Qualifications:** + Active and Unrestricted RN license in NJ + 3+ years clinical practice… more
    CVS Health (07/12/25)
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