• Care Manager II

    AmeriHealth Caritas (Columbia, SC)
    …record/documentation systems is essential **Licensure** + Must hold a current and unrestricted Registered Nurse ( RN ) license in good standing in South ... with treatment plans and promote self-management.; **Work Arrangement** + Remote ; + Community Visits - Residency in Rock Hill,...and evaluation of the effectiveness of the plan + Review medication list and educate Members with pharmacy needs,… more
    AmeriHealth Caritas (07/27/25)
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  • Care Manager

    AmeriHealth Caritas (Southfield, MI)
    …Health preferred + 3+ years of clinical experience at the bedside (as a Registered Nurse ) working with medically fragile patients in an acute care, home ... within a managed care organization, desired. **Licensure** + Current and unrestricted Registered Nurse licensure + Valid driver's license and car insurance.… more
    AmeriHealth Caritas (07/10/25)
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  • Quality Management, Nurse Consultant

    CVS Health (Tallahassee, FL)
    …clinical judgement as well as knowledge of internal systems. **Required Qualifications** - Registered Nurse ( RN ) with current unrestricted compact license ... all with heart, each and every day. **Position Summary** This is a full-time remote opportunity. Working schedule is _Monday through Friday, 8:00 AM -5:00 PM Eastern… more
    CVS Health (08/08/25)
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  • Care Manager

    AmeriHealth Caritas (Southfield, MI)
    …in Nursing preferred. + 3+ years of clinical experience at the bedside (as a Registered Nurse ) working with medically fragile patients in an acute care, home ... and evaluation of the effectiveness of the plan. + Review medication list and educate Members with pharmacy needs,...driver's license and car insurance. + Current and unrestricted Registered Nurse licensure. + Eligible to sit… more
    AmeriHealth Caritas (07/27/25)
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  • Licensed Practical Nurse - Outpatient…

    WellSpan Health (Lewisburg, PA)
    …or + Licensed Practical Nurse Multi State License Upon Hire Required or + Licensed Registered Nurse Upon Hire Required or + Registered Nurse Multi ... as a nursing resource for clinical staff. **Duties and Responsibilities** ** Remote Work Capable** **Essential Functions:** + Obtains patient history and gathers… more
    WellSpan Health (07/22/25)
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  • Licensed Practical Nurse Outpatient…

    WellSpan Health (York, PA)
    …or + Licensed Practical Nurse Multi State License Upon Hire Required or + Licensed Registered Nurse Upon Hire Required or + Registered Nurse Multi ... as a nursing resource for clinical staff. **Duties and Responsibilities** ** Remote Work Capable** **Essential Functions:** + Obtains patient history and gathers… more
    WellSpan Health (07/18/25)
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  • Licensed Practical Nurse -Outpatient - MSL…

    WellSpan Health (Gettysburg, PA)
    …or + Licensed Practical Nurse Multi State License Upon Hire Required or + Licensed Registered Nurse Upon Hire Required or + Registered Nurse Multi ... as a nursing resource for clinical staff. **Duties and Responsibilities** ** Remote Work Capable** **Essential Functions:** + Obtains patient history and gathers… more
    WellSpan Health (07/08/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …Auth/Denial Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have ... Job Description Remote work available! Up to $10,000 Sign on...proficient writing skills.Experience in Utilization Review and InterQual required. CARDIOPULMONARY RESUSCITATION… more
    Arnot Health (08/08/25)
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  • Medical Records Technician II- Cmhhip

    State of Colorado (Pueblo, CO)
    …Commission, CMS, and ORYX. This position provides back-up to the MRT III for utilization review . This position supports and provides back-up for all other duties ... requirements. + Keep a record of due dates for RN annual assessments, and Social Work and Psychiatric biannual...for each insurance carrier, and all departments/persons involved in utilization review . + Submits appropriate medical record… more
    State of Colorado (08/01/25)
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  • Director Clinical Documentation Integrity

    Tufts Medicine (Burlington, MA)
    …technology. **Job Description** **Minimum Qualifications:** 1. BSN degree 2. Licensed as a Registered Nurse 3. Five (5) years relevant experience in the ... Location: Remote with occasional onsite travel required ​ **Job...multiple revenue cycle and hospital departments, such as Coding, Utilization Management (UM), Case Management, Quality and Physician advisors… more
    Tufts Medicine (07/04/25)
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