Become a part of our caring community The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting data, criteria, policies, and procedures to provide the best and most appropriate treatment, care or
About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while working remotely. Primary Responsibilities • Performs
Job DetailsJob Location: Huntington Beach Office - Huntington Beach, CA 92647Position Type: Full TimeSalary Range: $34.98 - $42.85 HourlyRemote in California onlyAre you ready to make a lasting impact and transform the healthcare space? We are
Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine
Location:Remote - Ohio Department:Utilization Management Weekly Hours:20 Status:Part time Shift:Variable (United States of America) Pay Grade:$32.25 - $47.00 This is a remote position; however, employment is limited to residents of certain U.S. states due to legal, tax, and
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves
At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on
Job Description SummaryThe LPN Care Team Member is responsible for conducting Chronic Care Management (CCM) outreach to patients with two or more chronic conditions. This role supports ongoing care coordination, improves patient outcomes, reduces avoidable hospitalizations and
General Information Press space or enter keys to toggle section visibility Work Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 8:00am - 5:00pm PST Posted Date 06/15/2026 Salary Range:
Position Title Care Management Nurse Days - Full Time Broadmoor Campus, Remote Position Summary / Career Interest:The Care Management Nurse provides intervention for patients enrolled in the care management program; develops comprehensive plan of care for patients individual needs that transition
Sierra Drive Campus 1040 Sierra Dr Greenwood, Indiana 46143 The Utilization Management Assistant performs secretarial or clerical functions to support the administrative operations of the Utilization Management department. This position assists by reviewing and scanning prior authorization forms into the
Experience these exceptional benefits when you join Med-Metrix! • 8-Hour Shifts • Day 1 HMO with 2 of your dependents covered for FREE • Group Life Insurance • Medical Cash Allowance • Rice Allowance • Clothing
Job Description This role is fully remote and must be located within the 50 U.S. states. Standard working hours are in Eastern Timezone. Semi-annual travel may be required to a Devoted office for on-site work. A
If you are a current University Health or University Health Physicians employee and wish to be considered, you must apply via the internal career site. Please log into myWORKDAY to search for positions and apply.Utilization Management RN -
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on
City/StateNorfolk, VA Work ShiftFirst (Days) Overview: Sentara Health Plans is hiring an Utilization Review Nurse/RN- Remote in Virginia Status: Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F Location: Remote in Virginia Job responsibilities:
Become a part of our caring community The Risk Management Professional 2 is responsible for leading and executing quality audits within the CenterWell Utilization Management (UM) program, ensuring compliance with regulatory requirements, including CMS and NCQA standards. This role