Molina Healthcare Services (HCS) is seeking a Registered Nurse Case Manager for their Complex Adult Case Management program. This remote position, based in New York, involves supporting members with high need potential by assessing, facilitating, planning, and coordinating integrated delivery of care across the continuum, including behavioral health and long-term care. The role requires a nurse with previous case/care management and managed care experience, preferably with knowledge of managing complex/chronic medical conditions and community resources for social determinants of health concerns.

Registered Nurse Case Manager Complex Care Remote in New York

Registered Nurse Case Manager Complex Care

The Nurse Case Manager I at Elevance Health is responsible for performing care management within the scope of licensure for members with complex and chronic care needs. This includes assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize member health care across the care continuum. The role is virtual and requires a minimum of 3 years of clinical experience, a BA/BS in a health-related field, and current, unrestricted RN license in applicable states.

Nurse Case Mgr I

Nurse Case Manager I

Pyramid Consulting, Inc. is seeking a talented Registered Nurse/Consultant Training for a 12+ months contract opportunity in Austin, TX, with long-term potential. The role involves facilitating a library of 33 virtual instructor-led medical webinars for CE credit, updating webinar material, and acting as a resource for trainers and specialists. This position requires advanced-level technical training and serves as the highest level technical professional within the organization.

Registered Nurse/ Consultant Training

Registered Nurse/Consultant Training

Paradigm is seeking a Bilingual Field Nurse Case Manager to cover Phoenix, AZ, and surrounding areas. This remote, home-based position involves local travel to doctors' offices, hospitals, and various locations for the medical case management of work-related injuries. Responsibilities include assessment, planning, coordination, implementation, and evaluation of injured/disabled individuals, working closely with insurance carriers, medical care providers, attorneys, employers, and employees.

Bilingual Nurse Case Manager - Phoenix, AZ

Bilingual Nurse Case Manager

The Registered Nurse for PreCert and Appeals at ProMedica Health System performs prior authorization/certification of scheduled services with payers and assists with the appeal process when needed. This role involves clinical review and document submission for oncology treatments plans and services, interfacing with payers on plan medical coverage policies, and managing denial reports. The position is remote, ideally within 120 miles of Toledo, OH, and requires a nursing degree, 2 years of clinical experience, and familiarity with ICD10 and CPT codes.

RN / Registered Nurse - PreCert and Appeals - Remote - Per Diem - Days

Registered Nurse - PreCert and Appeals

The Michigan Licensed Nurse/Certified Case Manager at KYYBA is a fully remote position responsible for leading the coordination of a multidisciplinary team to deliver holistic, person-centric care management programs to a diverse health plan population. This role involves assessing, developing, implementing, monitoring, and evaluating care plans to optimize members' health across the care continuum. The position requires a Michigan licensed nurse with a CCM license and focuses on engaging members, providers, and community resources to develop and implement individualized care plans.

Mi licensed nurse/certified Case Manager/CCM

Michigan Licensed Nurse/Certified Case Manager

The Utilization Management Review Nurse will conduct reviews for hospitalizations, post-acute admissions, prior authorizations, and appeals, using national standard guidelines to determine if the clinical information meets criteria. This role involves working collaboratively with medical directors and case managers, assessing and planning healthcare services for members, and communicating with providers to facilitate care. The position is full-time, remote, and requires strong organizational, communication, and multitasking skills.

Utilization Management Review Nurse

Jacoby & Meyers is seeking an experienced Case Manager to join their team. This role involves interviewing new clients, setting up appointments, collecting information and documentation to build client cases, and ensuring compliance with appointment schedules. The position offers full training on the firm's software and requires a proactive, organized, and detail-oriented individual with strong communication skills and the ability to multitask. This is a full-time, remote position with a pay range of $25.00 to $40.00 per hour.

Experienced Case Manager

Molina Healthcare Services (HCS) is seeking a Registered Nurse Case Manager for its Maternity Care Management program. This remote position, based in the Western NY region, involves supporting members through their maternity care journey, including prenatal, birth, and postpartum care. The role includes comprehensive assessments, developing and implementing care plans, conducting home visits, and ensuring quality, cost-effective care. New York RN licensure is required, and bilingual Spanish speakers are encouraged to apply.

Registered Nurse Case Manager Maternity Care Remote In New York

Registered Nurse Case Manager Maternity Care

The Remote Triage Registered Nurse / RN supports patients and their families by providing clear, safe, and effective telephone triage using evidence-based processes and tools. This role involves critical thinking skills blended with a decision support tool to enable standardized care for the patient population. The position is fully remote with a 3-week rotation schedule, including one weekend every 3 weeks, and requires a compact/multistate RN license and a California single state license.

Triage Registered Nurse (Fully Remote)

Triage Registered Nurse

The Pediatric Case Manager RN at CVS Health supports a population of primarily medically complex pediatric members across various lines of business, focusing on those receiving private duty nursing and nursing facility services. This remote role involves telephonic and face-to-face assessments, planning, implementing, and coordinating care management activities to ensure members' medical and behavioral health needs are met. The position requires advanced clinical judgment, critical thinking skills, and the ability to work collaboratively with members, their care teams, and healthcare providers.

Pediatric Case Manager RN - Orlando, FL

Pediatric Case Manager RN

The Nurse Case Manager Senior at Elevance Health is responsible for collaborating with healthcare providers and/or consumers to drive personalized health management and improve health outcomes for optimal consumers. This role involves performing care management activities within the scope of licensure for members with complex and chronic care needs, ensuring medically appropriate, high-quality, cost-effective care, and implementing and coordinating a care plan.

Nurse Case Manager SR-1

Nurse Case Manager Senior

Sunbelt Staffing is seeking skilled and compassionate Registered Nurses (RNs) for contract positions in Warrenton, offering both local and travel assignments. The role involves delivering high-quality nursing care in the home setting, conducting patient assessments, administering medications, and maintaining accurate medical records. OASIS proficiency is required, and previous geriatric home health experience is preferred.

Home Health Contract Registered Nurse - Warrenton

Contract Registered Nurse

The Nurse Manager at WellGuide Health will manage the utilization management team and case management team, including prior authorization, utilization review, appeals, and case management. This role involves close collaboration with the director of clinical operations and focuses on enforcing policies, conducting chart audits, monitoring productivity, and addressing staffing and training needs. This is a full-time remote position that may require working evenings, weekends, and holidays.

Nurse Manager

Allara Health is seeking Advanced Practice Registered Nurses (APRN) to provide comprehensive care to patients, including diagnosis, treatment, and management of chronic and acute conditions, via video. The role involves conducting patient assessments, developing personalized treatment plans, collaborating with a multidisciplinary team, and engaging in preventative care. This position offers a 100% remote, telehealth role with a flexible schedule, malpractice insurance, and a supportive work environment.

Women's Health - APRN (New Jersey license) - Telemedicine

Advanced Practice Registered Nurse

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