• Telephonic Nurse Case Manager

    ICW Group (Las Vegas, NV)
    …assessment and evaluate needs for treatment in worker's compensation claims. The Telephonic Nurse Case Manager will negotiate and coordinate appropriate medical ... regulatory standards. + Interfaces with external agencies in relation to the utilization review process including, Third-Party Payers, Insurance Companies and… more
    ICW Group (06/18/25)
    - Related Jobs
  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/clinical/or combination; 2 of 4 years ... have critical thinking skills. Experience in case management or care coordination and telephonic care experience is preferred. + A typical day would be managing a… more
    US Tech Solutions (05/17/25)
    - Related Jobs
  • Utilization Management Nurse

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
    LA Care Health Plan (06/13/25)
    - Related Jobs
  • Acute Care Case Manager , Registered Nurse

    ChenMed (North Miami Beach, FL)
    …assess and record patients' progress and adjust and plan accordingly. + Understanding utilization review and how to leverage with inpatient staff for possible ... great people to join our team. The Acute Care Nurse (RN) is responsible for achieving positive patient outcomes...experience required. + A minimum of 1 year of utilization review and/or case management, home health,… more
    ChenMed (05/28/25)
    - Related Jobs
  • Registered Nurse - Call Center Women's…

    Option Care Health (Austin, TX)
    telephonic nursing support and management. + Provide excellent communication to nurse colleagues regarding patients on service with review of current status, ... best and brightest talent in healthcare. **Job Description Summary:** Responsible for telephonic management of patients at the telephonic center. **Job… more
    Option Care Health (06/17/25)
    - Related Jobs
  • Registered Nurse - Disease Management

    Matrix Providers (Fairfield, CA)
    …Case Management Society of America (CMSA); American Accreditation Healthcare Commission/ Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health ... Registered Nurse - Disease Management Location: Fairfield, CA, United...facility treatment team referrals. Facilitates identification, adoption, implementation and utilization of standardized clinical practice guidelines and protocols for… more
    Matrix Providers (05/30/25)
    - Related Jobs
  • 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 (06/17/25)
    - Related Jobs
  • Clinical Registered Nurse

    Sharecare (Orem, UT)
    …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is ... To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and objectives of the… more
    Sharecare (06/06/25)
    - Related Jobs
  • R&E Nurse - Med Care Services- Intermediate

    Health Advocates Network (Pittsburgh, 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- Intermediate **Pay Rate:** $25...(MA), health care services, human services, long term care, utilization review , or knowledge of home care… more
    Health Advocates Network (06/12/25)
    - Related Jobs
  • Registered Nurse , Case Manager - Oncology…

    CVS Health (St. Paul, MN)
    …with transferring patients to lower levels of care. - 1+ years' experience in Utilization Review . - CCM and/or other URAC recognized accreditation preferred - 1+ ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (06/25/25)
    - Related Jobs