• Telephonic Nurse Case Manager II

    Elevance Health (Denver, CO)
    ** Telephonic Nurse Case Manager II** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person ... members in different states; therefore, Multi-State Licensure will be required.** The ** Telephonic Nurse Case Manager II** is responsible for care management… more
    Elevance Health (08/29/25)
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  • Telephonic Behavior Health Care Manager

    Humana (Hallandale Beach, FL)
    …ensure interaction between the company and members are optimized. The Telephonic Behavioral Health Care Manager Internship provides transitioning service members ... requirements to achieve and/or maintain optimal wellness state in a remote telephonic environment. The Behavioral Health Care Manager guides members and/or families… more
    Humana (07/15/25)
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  • Acute Care Manager, Complex Care (Registered…

    ChenMed (Pembroke Pines, FL)
    …engagement with patient and family. + Facilitate patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... we need great people to join our team. The Nurse Case Manager I position is responsible for achieving...achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from… more
    ChenMed (08/16/25)
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  • Disease Management Nurse - Remote

    Sharecare (Nashville, TN)
    utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and objectives of the… more
    Sharecare (08/13/25)
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  • Managed Long Term Services and Supports…

    LA Care Health Plan (Los Angeles, CA)
    …such as ambulatory care, home care, palliative care, hospice care OR experience in Utilization Review or Care Management will be considered in lieu of direct ... Managed Long Term Services and Supports Nurse Specialist RN II Job Category: Clinical Department:...and/or disabilities in a UM/CM environment. Preferred: Experience in utilization review , skilled nursing, home health, discharge… more
    LA Care Health Plan (08/26/25)
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  • Registered Nurse - Care Coordinator

    Veterans Affairs, Veterans Health Administration (Gainesville, FL)
    …and from the community. Possesses the knowledge related to VHA guidelines, utilization review criteria, current evidence-based standards of care, compliance ... Health System (NF/SG VAHS) is recruiting for a Registered Nurse Care Coordinator to work in the Office of...to achieve desired patient outcomes through day-to-day and/ or telephonic care coordination and management. The RN Care Coordinator… more
    Veterans Affairs, Veterans Health Administration (08/28/25)
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  • R&E Nurse - Med Care Services- Expert

    Health Advocates Network (Harrisburg, PA)
    …setting, behavioral health setting, drug and alcohol setting, managed care, quality management/ utilization review or other related clinical experience; or An ... R&E Nurse - Med Care Services- Expert **Pay Rate:** $32...(MA), health care services, human services, long term care, utilization review , or knowledge of home care… more
    Health Advocates Network (08/28/25)
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  • Nurse - Perioperative Screening

    Veterans Affairs, Veterans Health Administration (Fayetteville, AR)
    …the perioperative central scheduling office, perform a thorough historical chart review , perform a telephonic screening, provide patient education, and ... Summary The Perioperative Screening Nurse ( Nurse Navigator) is responsible for...education, orientation, competencies and providing quality improvement and outcomes utilization . Coordinates and collaborates with other VA and non-VA… more
    Veterans Affairs, Veterans Health Administration (08/27/25)
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  • Behavioral Health Nurse - Managed Care

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …+ Participate in interdisciplinary case rounds, quality improvement initiatives, and utilization review processes. + Support members during transitions of ... Position is On-Site The Behavioral Health Nurse - Managed Care is responsible for coordinating,...+ Experience in a managed care, case management, or utilization review setting + Strong understanding of… more
    DOCTORS HEALTHCARE PLANS, INC. (08/24/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Juneau, AK)
    …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (08/15/25)
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