• Utilization Management Nurse

    Humana (Denver, CO)
    …and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
    Humana (12/17/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Cincinnati, OH)
    ** Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... 48 hours of receipt and meet the criteria._** The ** Telephonic Nurse Case Manager II** is responsible...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum requirements:**… more
    Elevance Health (12/17/25)
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  • Telephonic Nurse Case Manager I

    Elevance Health (Atlanta, GA)
    …criteria._** The ** Telephonic Nurse Case Manager I** is responsible for telephonic care management within the scope of licensure for members with complex ... ** Telephonic Nurse Case Manager I** **Location:...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (12/13/25)
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  • Senior Medical Management Nurse

    Ventura County (Ventura, CA)
    …and patient-centered care. Under general direction, the Senior Medical Management Nurse is responsible for performing utilization review, case management ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5113983)...in Case Management , CCM. + Experience with Utilization Management and/or Quality Assurance in a… more
    Ventura County (12/07/25)
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  • Acute, Nurse Case Manager

    ChenMed (Houston, TX)
    …We're rapidly expanding and we need great people to join our team. The Nurse Case Manager 1 (RN) is responsible for achieving positive patient outcomes and managing ... into acute and post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves establishing relationships with patients'… more
    ChenMed (12/09/25)
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  • Registered Nurse - Case Management

    ERP International (Luke AFB, AZ)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a full time **Registered Nurse - Case Management ** in support of the56th Medical Group at Luke AFB, AZ… more
    ERP International (11/25/25)
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  • Remote Health Plan Nurse Coordinator

    Actalent (Santa Barbara, CA)
    …Pediatric-Whole Child Model, and Population Health programs. The role involves performing utilization management activities, including telephonic or onsite ... Job Title: Health Plan Nurse CoordinatorJob Description The Health Plan Nurse...to various Health Services operational units. These units include Utilization Management , Case Management , Enhanced… more
    Actalent (12/12/25)
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  • Registered Nurse , Per Diem

    Fenway Health (Boston, MA)
    …objective scientific principles, and the patient's subjective experiences. + Conducts virtual, telephonic , or in-person nurse assessment and triage to assess the ... Registered Nurse , Per Diem Boston, MA (http://maps.google.com/maps?q=1340+Boylston+St+Boston+MA+USA+02215) * Nursing...to the care team with primary responsibilities for disease management , care coordination, and advice/triage needs for the care… more
    Fenway Health (12/16/25)
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  • Nurse Case Mgr I

    Elevance Health (Louisville, KY)
    ** Telephonic Nurse Case Manager II** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... - Friday **,** 8:30-5 or 9:30-6 pm EST. The ** Telephonic Nurse Case Manager II** is responsible...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
    Elevance Health (12/19/25)
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  • Registered Nurse - ISP Care Coordinator…

    Cedars-Sinai (Beverly Hills, CA)
    …reporting to the TPL carrier of all injured worker cases receiving case management services. + Ensures appropriate utilization of medical services within the ... Doing** The Case Manager is responsible for the case management of patient while hospitalized and upon discharge from...of care. Use evidence based review guidelines to conduct utilization review as is appropriate to match the payor… more
    Cedars-Sinai (11/25/25)
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  • Registered Nurse - Case Manager

    ERP International (Hurlburt Field, FL)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a full time **Registered Nurse (RN) Case Manager** in support of the 1st Special Operations Medical Group at Hurlburt… more
    ERP International (11/20/25)
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  • Registered Nurse - Case Manager

    ERP International (Anchorage, AK)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking a **Registered Nurse Case Manager** for a full-time position supporting the673d Medical Group, Joint Base… more
    ERP International (12/18/25)
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  • Registered Nurse - Case Manager

    ERP International (Twentynine Palms, CA)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International is seeking **Registered Nurse (RN) Case Managers** for full-time positions in support of the **Naval Hospital Twentynine Palms, CA**… more
    ERP International (11/20/25)
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  • Nurse Case Manager - FT Days

    Nuvance Health (Poughkeepsie, NY)
    …case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within ... - Discharge Planning primarily Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the… more
    Nuvance Health (09/28/25)
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  • Registered Nurse , ER, RN, Remote Triage

    ChenMed (St. Louis, MO)
    …rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional patient ... client counseling, patient advocacy, health education and referral and resource management to ChenMed patients and their families. Providing on-call coverage, the… more
    ChenMed (11/08/25)
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  • Access Nurse

    Cleveland Clinic (Port Saint Lucie, FL)
    …request in accordance with standard operating procedures. Standard operating procedures include utilization of telephonic interaction as the primary mode of ... designated to ensure the safe and efficient placement of patients and effective utilization of resources. + Demonstrate cost effective management of enterprise… more
    Cleveland Clinic (12/17/25)
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  • Registered Nurse - Case Manager

    ERP International (Tinker AFB, OK)
    …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... **Overview** ERP International, LLC is seeking a **Registered Nurse - Case Manager** for a full-time position supporting **SHG Clinic** in support of **Tinker AFB,… more
    ERP International (09/30/25)
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  • Registered Nurse

    US Tech Solutions (Columbia, SC)
    …enrollment in care management programs and/or health and disease management programs. Provides telephonic support for members with chronic conditions, ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to… more
    US Tech Solutions (12/13/25)
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  • Family Care-Registered Nurse

    Elevance Health (Darlington, WI)
    …communities. The **LTSS Service Coordinator-RN Clinician** is responsible for overall management of member's case within the scope of licensure, develops, monitors, ... **How you will make an impact:** + Responsible for performing telephonic and face-to-face functional assessments for the identification, evaluation, coordination and… more
    Elevance Health (11/13/25)
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  • Registered Nurse

    US Tech Solutions (Columbia, SC)
    …Promotes enrollment in care management programs and/or health and disease management programs. + Provides telephonic support for members with chronic ... established clinical criteria to service requests or provides health management program interventions. **Responsibilities:** + Utilizes clinical proficiency and… more
    US Tech Solutions (11/25/25)
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