• Manager , Utilization Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …Other duties as assigned. Essential Qualifications + Active and unrestricted license as a Registered Nurse ( RN ) + Bachelor's degree in nursing, (or ... About The Role The Manager , Utilization Management (UM) will manage...Experience working within a TPA environment. + Experience with Case Management + Familiarity with call center operations +… more
    Brighton Health Plan Solutions, LLC (10/11/25)
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  • Remote RN Case Manager

    Actalent (Orlando, FL)
    Remote RN Case Manager Job Description We are seeking a dedicated RN Case Manager to perform telephonic case management for Medicare ... new cases in Athena EMR. Responsibilities + Perform telephonic case management for Medicare Advantage members. + Coordinate care...new cases using Athena EMR. Essential Skills + Valid RN license in Florida. + Minimum of 2 years… more
    Actalent (11/06/25)
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  • RN Case Manager , Home Health…

    Good Samaritan (Omaha, NE)
    …working to provide the best care in the homes of our clients. We are looking for a Registered Nurse looking to work 32 hours a week or more. We look forward to ... outcomes based on an integration among established clinical, financial and utilization data. Functions in structured and unstructured health care settings described… more
    Good Samaritan (10/28/25)
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  • Case Manager , RN

    Northwell Health (Staten Island, NY)
    …Nursing, required. + Current license to practice as a Registered Professional Nurse in New York State. + Case Management Certification, preferred. + Minimum ... delays and resolves issues with appropriate departments. + Identifies appropriate utilization of Social Work Services and makes referrals when appropriate. +… more
    Northwell Health (11/07/25)
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  • RN Case Manager

    Trinity Health (Livonia, MI)
    …Rotating Shift **Description:** **An Opportunity to Join our Remarkable Care Team as a** ** Case Manager ** **in the Case Management Department awaits YOU ** ... excellence in clinical outcomes, patient safety, financial performance and efficiency. **SUMMARY:** A Case Manager is required to function at an advanced level… more
    Trinity Health (11/08/25)
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  • RN OB Case Manager

    Highland Hospital (Rochester, NY)
    **17006BR** **Title:** RN OB Case Manager ...of the Highland Women's Health (HWH) Nurse Manager and Division Director, the OB RN ... Manager 's central role integrates and coordinates access and utilization management, proactive patient management, care facilitation and treatment planning… more
    Highland Hospital (09/16/25)
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  • Mission Control RN FT Nights

    AdventHealth (Orlando, FL)
    …role you'll contribute:** The Mission Control RN Tier 1 is a professional registered nurse functioning withing Mission Control in one of three primary roles. ... provides information to the Utilization Review Specialist, Utilization Review Case Manager and...State of Florida or multi state license as a Registered Nurse . Graduate of school of Nursing… more
    AdventHealth (11/06/25)
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  • RN Case Manager - Alton…

    BJC HealthCare (Alton, IL)
    …at this time **Additional Preferred Requirements** + At least 5 years of hospital-based RN experience + Prior Case Management experience + Proficient in EPIC ... cancer care, rehabilitation, 24-hour emergency care, ambulance services and more. Case Management, Utilization Review, Social Services: Provides admission and… more
    BJC HealthCare (11/05/25)
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  • SKY Complex Care Manager - Case

    CVS Health (Frankfort, KY)
    …And we do it all with heart, each and every day. **Position Summary** The Complex Nurse Case Manager is responsible for assessing members through regular and ... to facilitate and support the member's improved health. The Case Manager develops a proactive course of...experience including patient care coordination and health assessments. + RN with current unrestricted state licensure required. + 2+… more
    CVS Health (10/01/25)
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  • RN Case Manager PRN

    CommonSpirit Health (Lakewood, CO)
    …with resources to help you flourish and leaders who care about your success. RN Case Manager you'll advocate for patients while collaborating closely ... to resources that help them maintain and build on positive outcomes. In the role of RN Case Manager , you will also: + Utilize clinical expertise, discretion,… more
    CommonSpirit Health (11/07/25)
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