• Nurse

    Veterans Affairs, Veterans Health Administration (Las Vegas, NV)
    …systematic evaluation and analytical review of clinical information. Responsibilities The Revenue Utilization Review (RUR) Registered Nurse is under the ... of revenue reimbursement processes and under moderate supervision and instruction by the registered nurse manager. Responsibilities of the RUR nurse include,… more
    Veterans Affairs, Veterans Health Administration (11/16/25)
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  • Manager, Healthcare Services (Wisconsin Rapids,…

    Molina Healthcare (Montello, WI)
    …experience. * At least 1 year of health care management /leadership experience. * Registered Nurse ( RN ), Licensed Vocational Nurse (LVN), Licensed ... skills. * Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications * Registered Nurse ( RN ). License must be active and… more
    Molina Healthcare (11/13/25)
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  • Clinical Guide

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …clinical experience * 1+ years of medical call center or managed care experience; eg case management , utilization management * All relevant experience ... resources to support the member holistically. Facilitates referrals to Case Management Programs as appropriate. * Gathers...clinical and service availability. Required Skills and Experience * RN with MN license or LSW with no restrictions… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • MDS Coordinator

    Elderwood (Hamburg, NY)
    Salary Up to $49.50 / Hour Overview Elderwood at Hamburg is seeking a Registered Nurse ( RN ) to join our clinical team as a MDS Nurse . Position Overview: ... + An MDS (Minimum Data Set) nurse , or nurse assessment coordinator, collects and...facility policies. + Actively participate in utilization management processes, including PDPM and state case more
    Elderwood (10/13/25)
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  • Lead Advanced Practice Provider - Outpatient…

    Stanford Health Care (Palo Alto, CA)
    …their APPs. Also functions under the general Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), or ... a licensed advanced practice provider: (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist or Certified Registered Nurse Anesthetist). +… more
    Stanford Health Care (11/16/25)
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  • Manager Care Management - UNC Disposition…

    UNC Health Care (Chapel Hill, NC)
    …lead a skilled group of care managers and social workers. Candidates must be a Registered Nurse ( RN ) or Licensed Clinical Social Worker (LCSW). Preference ... operations for designated Clinical Care Management Department team(s). Provides management direction to Case Managers, Utilization Managers, Clinical… more
    UNC Health Care (11/22/25)
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  • Clinical Documentation Specialist - Home…

    Sanford Health (SD)
    …Additionally, three years of recent clinical nursing experience required. Experience in case management , utilization management , and/or coding ... **Job Summary** The Clinical Documentation Specialist (CDS) communicates with providers, case managers, coders, and other healthcare team members to facilitate… more
    Sanford Health (10/15/25)
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  • Mental Health Program Manager I/Emergency…

    The County of Los Angeles (Los Angeles, CA)
    …mental health team. Option III : A valid, current license to practice as a registered nurse issued by the appropriate State of California licensing agency -AND- ... practice. + Participates in the development, negotiation, implementation, and management of the budget for the program support service...have a valid, current license to practice as a registered nurse issued by the appropriate State… more
    The County of Los Angeles (11/09/25)
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  • Care Manager (Remote)

    CareFirst (Baltimore, MD)
    …**Education Level:** High School Diploma or GED. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... State Licensure RN - Registered Nurse in MD, VA or Washington....+ Bachelors degree in nursing. + CCM/ACM or other RN Board certification in case management more
    CareFirst (10/10/25)
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  • Care Management Specialist II, D-SNP Team…

    LA Care Health Plan (Los Angeles, CA)
    …Certified Case Manager (CCM) Accredited Case Manager (ACM) Certification Case Management Nurse - Board Certified (CMGT-BC) Required Training Physical ... Care Management Specialist II, D-SNP Team (12 month Assignment)...Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN );current and unrestricted… more
    LA Care Health Plan (10/21/25)
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