• Unit Manager Clinical Operations

    Health Care Service Corporation (Richardson, TX)
    …the organization in delivery of services to the customer. **JOB REQUIREMENTS** **:** + Registered Nurse ( RN ), with current, unrestricted license to practice ... a variety of behavioral health clinical operations such as Utilization Management , Case Management and/or...years) at the independent practice level + If a Registered Nurse ( RN ): must have… more
    Health Care Service Corporation (10/15/25)
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  • Health Plan Nurse Coordinator

    Actalent (Santa Barbara, CA)
    …healthcare benefits, regulatory requirements, and professional nursing standards. Essential Skills + Registered Nurse ( RN ) license (California Valid) + ... Health Plan Nurse Coordinator (HPNC) is a Registered Nurse assigned to various Health Services... assigned to various Health Services operational units, including Utilization Management , Case Management , Enhanced… more
    Actalent (10/14/25)
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  • Social Worker - Rural Health (Master's level,…

    St. Luke's University Health Network (Tamaqua, PA)
    …Worker (OP CM SW) is responsible for providing Social Work and care management services to out-patients and their families (occasional in-patients) as directed by ... policies and procedures of the entity and Outpatient Care Management Department. The OP CM SW provides professionally established...CM SW also collaborates with the Outpatient Care Manager RN , Community Health Worker and extender staff as needed… more
    St. Luke's University Health Network (08/13/25)
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  • Manager, Care Management

    Humana (Springfield, IL)
    …+ **Must reside in the state of Illinois** + An active, unrestricted, Registered Nurse **( RN )** license, Licensed Clinical Social Worker **(LCSW)** ... health first** Humana Gold Plus Integrated is looking for Managers of Care Management who will lead teams of nurses, care coordinators and behavioral health… more
    Humana (08/29/25)
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  • Case Manager

    Apex Health Solutions (Houston, TX)
    …will consider remote deployment on a case by case basis Education Education: Registered Nurse ( RN ) LICENSES/CERTIFICATIONS: Registered Nurse ( ... and cooperates with internal and external stakeholders. Collaborates effectively with Utilization Management , Quality Management , Pharmacy, Provider… more
    Apex Health Solutions (08/24/25)
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  • Manager - Care Management

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …, and business case consultant for leadership as they relate to case/disease/ utilization management . * Coordinates the development, revision and implementation ... relations and cost control. Required Skills and Experience * Registered nurse or licensed behavioral health clinician...within insurance or health care setting in case/disease or utilization management * Bachelor's or Master's degree… more
    Blue Cross and Blue Shield of Minnesota (10/16/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have proficient ... Job Description Remote work available! Up to $10,000 Sign on...Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate… more
    Arnot Health (08/08/25)
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  • Behavioral Health Care Advisor - Substance Use…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …acute mental health challenges by providing culturally sensitive support. This role requires a Registered Nurse ( RN ) licensed in the state of Minnesota with ... to engage with members. Required Skills and Experiences * Registered Nurse with Psychiatric experience or Behavioral...* 1+ years of managed care experience, eg case management /health coach, utilization management and/or… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Care Manager II

    AmeriHealth Caritas (Detroit, MI)
    …required. + Bachelor of Science in Nursing preferred. + Current, active, and unrestricted Registered Nurse licensure. + 3 or more years of clinical experience at ... and compliance with treatment plans, as well as promote self- management . **Work Arrangement:** + Remote - The...the bedside (as a Registered Nurse ) working with medically fragile patients… more
    AmeriHealth Caritas (08/27/25)
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  • DRG Specialist II

    UPMC (Pittsburgh, PA)
    … Health Information Administrator OR Registered Health Information Technician (RHIT) OR Registered Nurse ( RN ) + Act 34 Current licensure either in ... Friday during daylight hours. The position will be fully remote ! In this role, the DRG Specialist II will...Specialist (CCS) OR Certified Professional Coder (CPC) OR Certified Registered Nurse Practitioner OR Doctor of Medicine… more
    UPMC (09/25/25)
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