• Enhanced Care Management Clinical…

    LA Care Health Plan (Los Angeles, CA)
    …the coordination of member care with internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and ... aggregate progress and individual ECM member cases. May use telephonic , onsite, or written methods and both group and... Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance Salary Range Disclaimer:… more
    LA Care Health Plan (10/14/25)
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  • Care Management Associate - OhioRISE - Must…

    CVS Health (Columbus, OH)
    …each and every day. **Position Summary** MUST RESIDE IN OHIO The Care Management Associate (CMA) role is a full-time, predominately remote telework position. Some ... with special healthcare needs and carries a caseload. The Care Management Associate supports comprehensive coordination of medical services including Care Team… more
    CVS Health (10/15/25)
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  • RN Specialist Complex Care Case Management

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …Skills and Experiences * 2+ years of managed care experience; eg case management /health coach, utilization management and/or auditing experience (may be ... and Blue Shield of Minnesota Position Title: RN Specialist Complex Care Case Management Location: Remote Career Area: Health Services About Blue Cross and Blue… more
    Blue Cross and Blue Shield of Minnesota (10/08/25)
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  • Care Management Associate

    CVS Health (Baton Rouge, LA)
    …power of our people to transform health care. **Position Summary:** The Care Management Associate role is a full time remote telework position. Care Management ... welfare population health members, and carries a caseload. The Care Management Associates supports comprehensive coordination of medical services including Care Team… more
    CVS Health (10/18/25)
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  • RN Case Manager - Case Management…

    Cedars-Sinai (CA)
    …established/communicated timeframe + Documents appropriate reviews for assigned patients using utilization review tool. + Provides telephonic review for ... America's Best Hospitals! **What You Will Do in This Role:** A Registered Nurse Case Manager plans and coordinates care of the patient from pre-hospitalization… more
    Cedars-Sinai (10/19/25)
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  • Professional Care Manager, Supervisor (RN)

    UPMC (Pittsburgh, PA)
    …Supervisor is responsible for oversight and day-to -day care coordination functions for telephonic , clinical, or utilization management care management ... a full-time Professional Care Manager, Supervisor to join our Utilization Management (UM) Clinical Operations team. This...one year of hire or 1 year health plan management experience required + Registered Nurse (RN)… more
    UPMC (10/14/25)
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  • Clinical Denials Prevention & Appeals Specialist…

    Nuvance Health (Danbury, CT)
    …in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum ... members of the interdisciplinary care team * Current working knowledge of utilization management , performance improvement and managed care reimbursement. Working… more
    Nuvance Health (09/26/25)
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  • Clinical Care Manager (RN) - Shadyside

    UPMC (Pittsburgh, PA)
    …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan of care… more
    UPMC (10/17/25)
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  • RN-Case Manager

    ERP International (Macdill AFB, FL)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... ** Nurse (RN)** for Full-Time positions in **Case Management ** at MacDill AFB, FL. Apply online today and...and implement local strategies using inpatient, outpatient, onsite and telephonic CM * Develop and implement tools to support… more
    ERP International (08/20/25)
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  • RN Care Coordinator - Inpatient Specialty Program

    Cedars-Sinai (Beverly Hills, CA)
    …reporting to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the ... The RN Care Coordinator is responsible for the case management of patient while hospitalized and upon discharge from...of care. Use evidence based review guidelines to conduct utilization review as is appropriate to match the payor… more
    Cedars-Sinai (10/12/25)
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