• Clinical Reviewer III, Licensed/Remote (Louisiana)

    Magellan Health Services (Baton Rouge, LA)
    …- Care MgmtCare Mgmt, LPCC - Licensed Professional Clinical Counselor - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - ... management and verbal and written communication skills. Knowledge of utilization management procedures, Medicaid benefits, community resources and providers.… more
    Magellan Health Services (12/01/25)
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  • Care Management Specialist II, D-SNP Team…

    LA Care Health Plan (Los Angeles, CA)
    …Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN );current and unrestricted California ... Preferred Certified Case Manager (CCM) Accredited Case Manager (ACM) Certification Case Management Nurse - Board Certified (CMGT-BC) Required Training Physical… more
    LA Care Health Plan (10/21/25)
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  • LCSW/LMFT - Orange County

    Amergis (Orange, CA)
    …to help support a health insurance agency! The Medical Case Manager (BHI Utilization Management ) will be responsible for reviewing and processing requests for ... such as those listed above may also be qualifying. Preferred Qualifications: + Utilization management reviewer experience. + Managed care experience. + … more
    Amergis (11/05/25)
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  • Manager - Case Management

    Ascension Health (Wichita, KS)
    …/ Certification / Registration: + One or more of the following required: + Registered Nurse credentialed from the Kansas Board of Nursing obtained prior to ... areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and revise assignments daily to… more
    Ascension Health (11/14/25)
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  • Care Review Clinician - NM resident - Licensed LPN…

    Molina Healthcare (NM)
    …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse more
    Molina Healthcare (10/30/25)
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  • Case Manager

    AnMed Health (Anderson, SC)
    …databases and documentation systems as required. Qualifications + BSN and Current South Carolina Registered Nurse License; BSN required, but if no BSN at the ... health specialists, and nurses to achieve timely, appropriate patient management . + Utilizes the RN process as...as a collaborative team member. + Licensed as a Registered Nurse in South Carolina. + Minimum… more
    AnMed Health (09/17/25)
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  • Clinical Nurse Coordinator Medical Surgical

    HCA Healthcare (Las Vegas, NV)
    …we support our colleagues in their positions. Join our Team as a(an) Clinical Registered Nurse Coordinator- MedSurg and access programs to assist with every ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...certifications and job skills. Apply today for our Clinical Registered Nurse Coordinator- MedSurg opening and continue… more
    HCA Healthcare (10/25/25)
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  • Ambulatory Care Manager Social Worker MSW (Full…

    Penn Medicine (Lancaster, PA)
    …requirements being one of the following: RN : Current licensure as a Registered Nurse , issued by the Pennsylvania Board of Nursing. Bachelor's degree in ... management platform/analytics. + Analyzes data to identify under/over utilization ; improve resource consumption; promotes potential reduction in cost and… more
    Penn Medicine (12/04/25)
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  • Manager, Clinical Care Services

    Magellan Health Services (Albuquerque, NM)
    …Professional Counselor - Care MgmtCare Mgmt, PC - Professional Counselor - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - ... , direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management ...required: BCBA, LCSW, LMFT, LMSW, LPCC, LPC, PC or RN . If RN , BSN preferred but ASN… more
    Magellan Health Services (10/10/25)
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  • Nurse Manager Patient Throughput

    HCA Healthcare (Kissimmee, FL)
    …Cardiac Life Support must be obtained within 30 days of employment start date + ( RN ) Registered Nurse + Associate Degree, or Bachelors Degree Preferred HCA ... caregivers, case management , and admitting departments to promote effective utilization management through coordination of efforts involving patient flow.… more
    HCA Healthcare (12/11/25)
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