• Virtual Registered Nurse

    Trinity Health (Mishawaka, IN)
    …is NOT a remote position.** **_About the job:_** The licensed Registered Nurse (RN) plans & provides professional nursing services & standards of practice in ... & Stewardship:** Incorporates caring process (Caritas), advocacy & appropriate resource utilization as an essential component of nursing practice through concrete… more
    Trinity Health (06/18/25)
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  • Senior Clinical Review Nurse

    Centene Corporation (Phoenix, AZ)
    …documented + Provides education to interdepartmental teams on training needed within the utilization management team based on trends + Provides feedback to ... experience. Expert of Medicare and Medicaid regulations preferred. Expert of utilization management processes preferred. **License/Certification:** + RN or LPN… more
    Centene Corporation (07/19/25)
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  • Clinical Review Nurse - Prior Authorization

    Centene Corporation (New York, NY)
    …preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN - ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
    Centene Corporation (06/18/25)
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  • Supervisor, Intensive Community Care - Registered…

    ChenMed (Winter Park, FL)
    …license required if available in state. + A minimum of 2 years' onsite case management at ChenMed and/or utilization review or discharge planning in a hospital ... markets to deliver on managing their case load by providing onsite and remote planning, clinical group leadership and expert technical guidance to their team.… more
    ChenMed (06/27/25)
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  • Licensed Practical Nurse / LPN

    InGenesis (Columbia, SC)
    …guidelines. In this role, you will provide support and review of medical claims and utilization practices. This is a REMOTE opportunity for a LPN living in the ... InGenesis is currently seeking a Licensed Practical Nurse / LPN to work remotely with our...operations of assigned area. * Interfaces with the medical management on a regular basis to work more complex… more
    InGenesis (05/16/25)
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  • Case Manager Registered Nurse - Field…

    CVS Health (East Orange, NJ)
    …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... County and surrounding counties. **Position Summary** This is a remote Case Manager opportunity with 50 to 75% field...Health service strategies, policies, and programs are comprised of utilization management , quality management , network… more
    CVS Health (07/18/25)
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  • Licensed Practical Nurse - Outpatient…

    WellSpan Health (Lewisburg, PA)
    …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... as a nursing resource for clinical staff. **Duties and Responsibilities** ** Remote Work Capable** **Essential Functions:** + Obtains patient history and gathers… more
    WellSpan Health (07/22/25)
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  • Licensed Practical Nurse Outpatient…

    WellSpan Health (York, PA)
    …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... as a nursing resource for clinical staff. **Duties and Responsibilities** ** Remote Work Capable** **Essential Functions:** + Obtains patient history and gathers… more
    WellSpan Health (07/18/25)
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  • Licensed Practical Nurse -Outpatient - MSL…

    WellSpan Health (Gettysburg, PA)
    …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... as a nursing resource for clinical staff. **Duties and Responsibilities** ** Remote Work Capable** **Essential Functions:** + Obtains patient history and gathers… more
    WellSpan Health (07/08/25)
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  • Clinical Review Nurse Care Manager

    Children's Mercy Kansas City (Kansas City, MO)
    …beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, evidence-based guidelines, insurance knowledge, ... business acumen, and high level of communication skills to ensure appropriate utilization of and reimbursement for resources from admission through hospital stay to… more
    Children's Mercy Kansas City (06/18/25)
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