• 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)** ... Care Management who will lead teams of nurses, care coordinators and behavioral health professionals responsible for care management . The Manager, Care … more
    Humana (08/29/25)
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  • Supervisor - Clinical

    Independent Health (Buffalo, NY)
    …with the core components of the client centric delivery model. **Qualifications** + Registered Nurse ( RN ) with active, current, unrestricted NYS license ... RN staff of their assigned area (Case Management , Utilization Review and Population Health). This...based on the needs of the patient. + Utilize behavioral strategies to help patients adopt healthy behaviors and… more
    Independent Health (10/19/25)
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  • Case Manager

    Apex Health Solutions (Houston, TX)
    …TX area; 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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  • Inpatient Nurse Reviewer

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... assignments. Qualifications: + Registered Nurse , Licensed Practical Nurse ...Florida. + 3 years minimum experience in discharge planning, utilization management , or case management .… more
    DOCTORS HEALTHCARE PLANS, INC. (10/16/25)
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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 ... accurate documentation of member interactions in the electronic care management platforms. + Monitor appropriate utilization and...the bedside (as a Registered Nurse ) working with medically fragile patients… more
    AmeriHealth Caritas (08/27/25)
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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 (08/14/25)
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  • Care Manager I - Transition in Care (Remote - Must…

    Houston Methodist (Houston, TX)
    …Houston area.** At Houston Methodist, the Care Manager I position is a licensed registered nurse ( RN ) who works collaboratively with the interprofessional ... healthcare team to provide professional nursing care and disease management to various population groups identified in the hospital...ambulatory care preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (09/09/25)
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  • Medical Management Clinician

    Elevance Health (Independence, OH)
    …moderately complex case types that do not require the training or skill of a registered nurse . **How you will make an impact.** Primary duties may include, but ... _‐_ _centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs._ **Medical… more
    Elevance Health (09/10/25)
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  • Care Manager, BH - Remote

    Magellan Health Services (Newtown, PA)
    …Counselor - Care MgmtCare Mgmt, LSW - Licensed Social Worker - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care ... with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN . Minimum 2 years experience post degree in healthcare,...time management and communication skills. Knowledge of utilization management procedures, mental health and substance… more
    Magellan Health Services (10/07/25)
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  • Throughput Coordinator Neonatal ICU

    HCA Healthcare (Austin, TX)
    …you will need:** Experience * 5 years of clinical nursing experience as a NICU Registered Nurse ( RN ) Education * Associates Degree in Nursing (ADN) * ... the patient flow program effectiveness as it relates to utilization review, resource management and discharge planning...preferred License and Certifications * Current State of Texas Registered Nurse ( RN ) license or… more
    HCA Healthcare (08/23/25)
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