• Case Manager, Registered Nurse…

    CVS Health (Salem, OR)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (07/18/25)
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  • Care Manager RN - ( Remote )

    Highmark Health (Salem, OR)
    …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
    Highmark Health (07/12/25)
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  • Utilization Management Nurse…

    CVS Health (Salem, OR)
    …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... remote role open to candidates with an active RN licensure in the state in which they reside....to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN… more
    CVS Health (07/23/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (Salem, OR)
    …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
    Prime Therapeutics (07/24/25)
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  • Disease Management Nurse - Remote

    Sharecare (Salem, OR)
    …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
    Sharecare (07/12/25)
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  • Clinical Appeals Coordinator

    Centene Corporation (Salem, OR)
    …nursing or case management experience. Managed care or utilization review experience preferred. **License/Certification:** LPN or Oregon RN nursing license ... Purpose:** Act as the liaison for all statewide appeals, fair hearings, review organizations, and other external type appeals. Responsible for ensuring that all… more
    Centene Corporation (07/16/25)
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  • LPN or MA Care Manager - Portland or Eugene

    Praxis Health (Portland, OR)
    …+ Ensure high-risk cases are included in the Interdisciplinary Team (IDT) agenda for review 3. High Emergency Room Utilization Oversight + Monitor and manage ... patient populations. Certification Required:LPN or Highly Skilled MA Location:In-House Only (No Remote ) Schedule:Full-time, Monday - Friday, 8:00 AM - 5:00 PM Why… more
    Praxis Health (07/23/25)
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