Remote RN Care Manager - Utilization & Care Coordination
Highmark Health
- Remote job
Highmark Health is seeking a full-time Remote Utilization Management/Case Management RN. The role reviews care appropriateness, applies criteria for resource use, refers to Health Coach/case management when needed, and analyzes data to improve provider and member satisfaction. Weekend availability plus three weekdays are required. Essential duties include operating care management reviews, meeting regulatory standards, coaching providers, and maintaining privacy. #J-18808-Ljbffr Highmark Health
- Highmark Health is seeking a remote Care Manager RN to support utilization management and care coordination. The role requires weekend availability (Saturday and Sunday) plus three weekdays, focusing on reviewing services, applying criteria, and improving member outcomes...Remote jobWeekend workWeekday work
- Highmark Inc. is seeking a full-time RN with utilization management expertise for a remote role requiring weekend availability (Saturday... .... The position focuses on reviewing care appropriateness, applying criteria, and coordinating with Health Coach/case management to...Remote jobFull timeWeekend workWeekday work
- Highmark Health is seeking a full-time, remote Care Manager with weekend availability to support utilization management and care coordination across Saturday, Sunday and three weekdays... ..., and resolving quality issues. Required RN licensure (PA or multi-state via eNLC) and...Remote jobFull timeWeekend workWeekday work
- Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations... ...Management team, which manages post-acute care services including SNF, Home Health, and DME....Remote job
- ...Humana Inc. is seeking a Utilization Management Registered Nurse to interpret and support the coordination, documentation and communication of medical services and benefit... ...Management team to ensure members receive appropriate care in the right setting. You will determine...Remote workWork from home
- ...Healthcare is seeking a registered nurse to support care management and care coordination activities remotely across the continuum of member care. You will work... ...services across behavioral health and LTSS, and utilizing motivational interviewing to drive member engagement...Remote job
- Molina Healthcare is seeking a Remote RN Care Manager to support our Washington State Health Plan. The role is remote... ...care. Key duties include assessing members, coordinating care plans, and monitoring progress while utilizing motivational interviewing #J-18808-Ljbffr...Remote job
- Highmark Health is seeking a Remote Nurse Care Manager to implement utilization management strategies across care settings. The role requires weekend availability... ...care appropriateness, applying criteria, and coordinating referrals to Health Coaching and case management....Remote jobWeekend workWeekday work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ..., which oversees post-acute care services including SNF, home... ...necessity and coordinate care, with potential remote #J-18808-LjbffrRemote work
- Highmark Inc. is seeking a remote RN Case Manager to support utilization management and care coordination. The role requires weekend availability (Saturday and Sunday) in addition to three weekdays, with duties spanning review of services, adherence to policies, and proactive...Remote jobWeekend workWeekday work
- ...Humana, Inc. is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ...UM team focused on post-acute care (SNF, Home Health, DME). The role requires a valid RN license, 1+ year of clinical RN...Remote work
- ...Humana Inc. is seeking a remote Utilization Management Registered Nurse to interpret clinical data and coordinate medical service determinations for home solutions and post‑acute care. You will review, document, and communicate with providers to ensure appropriate...Remote work
$84.14k - $126.22k
...Point32Health is seeking an RN Care Manager to ensure timely care management across the continuum... ..., including transitions of care, care coordination, and complex case management. Ideal for... ...range of $84,143–$126,215 per year, remote work in Massachusetts, and a $7,500 sign...Remote workRelocation package- ...Position TitleAmbulatory Clinic RN Care Coordinator - Cardiology-New patient... ...- Full TimeBell Hospital, Remote Position Summary /... ...Functions Responsible for management of patient flow, triage, and... ...defining appropriate resource utilization, and working with the...Remote workFull timeWork at office
- Humana is seeking a Utilization Management Registered Nurse to support coordination, documentation, and communication of medical services and benefit determinations for post-acute care, including SNF, home health, and DME. You will report to the Manager of Utilization...Remote job
- Humana is seeking an Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical services and benefit determinations. You will report to the Manager of Utilization Management and serve on the One Home/Home Solutions...Remote job
- Humana is seeking an Utilization Management Registered Nurse to interpret and support coordination, documentation, and communication of medical... ...UM team managing post-acute care services including SNF, home... .... The role requires an active RN license, 1+ year RN experience...Remote job
- Humana Inc. is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and determinations for medical services and benefit... ...Utilization Management team, focusing on post-acute care services including SNF, Home Health and DME....Remote job
- ...Description: Home Care & Hospice Virtual Care Center Coordinator Registered Nurse (RN) Hiring for the following... ...critical moments. Utilizing virtual platforms,... ...Leadership - Accessible managers who understand the... ...patients' conditions remotely. Develop and...Remote workFull timeTemporary workPart timeReliefLocal areaImmediate startMonday to FridayShift workWeekend work
- ...a Registered Nurse to support Utilization Management in a remote-friendly role. You will apply clinical... ...ensure appropriate services, coordinate with providers, and support care decisions in a fast-paced, tech-enabled environment. Required RN license and 2+ years in acute...Remote jobFlexible hours
- Humana is seeking a dedicated Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit... ...Management team, focusing on post-acute care services including SNF, Home Health and DME. You...Remote job
- Jackson Health System in Miami, FL seeks a Clinical Denials Coordinator to support the Utilization Review team within Revenue Cycle. Responsibilities... ...workflows. The role requires 3-5 years of related experience, RN background (ED/ICU/IR/OR preferred), InterQual review...Remote job
- ...Remote Full Time Days And Every Other Weekend RN Case Manager -Utilization ReviewJoin our team as a remote full time days and every... ...QUALIFICATIONSEXPERIENCE:Experience with managed care and payer/provider... ...resources.Recommends and coordinates timely transfers to...Remote workFull timeWork at officeShift workWeekend work
- ...Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to join our remote team on weekends after training. You will review... ...determinations and collaborate with providers to coordinate care, ensuring members receive appropriate care....Remote jobWork at officeWeekend work
- Centene is seeking a Registered Nurse to develop and coordinate complex care management for primarily physical needs members in Missouri. The role... ...Monday-Friday schedule, 8am-5pm, and the option to work remotely from home across the state. You will evaluate needs, create...Remote jobWork from homeMonday to Friday
$42 - $45 per hour
...Title: Care Management Coordinator/RN Location: 100% Remote Duration: 3+ Months (FT conversion) This is a Utilization Management RN part time position - working every other weekend (2 days a week in a 2 week cycle).*Must be available M-F 8:30-4:30pm for 2-3 weeks...Remote workHourly payFull timeTemporary workPart timeFlexible hoursWeekend work2 days per week- ...Registered Nurse to join our care management team serving the Austin... .... This role emphasizes care coordination for clients with complex medical... ...meaningful client interactions. The RN will conduct assessments,... ..., while primarily working remotely. #J-18808-Ljbffr Prestige...Remote jobWork from home
- Centene is seeking a registered nurse care manager to develop, assess, and facilitate complex... ...care plans, educate families, and coordinate with providers to address unmet needs.... ...Macomb counties, with the option to work remotely from home the remaining time. Mon-Fri,...Remote jobLocal areaWork from home
$38.66 - $58.32 per hour
...RN Care Coordinator Partnering for a stronger, healthier world. At CommonSpirit Health... ...2 Requisition ID: 2026-493468 Remote: No Weekly Schedule: Saturday and... ..., communicate, and collaborate with utilization management, nursing, physicians, ancillary departments...Remote workFull timeRelocation packageShift workWeekend workWeekday work$100k - $120k
...reimagining pediatric chronic care, starting with ADHD. After... ...on Obesity and Overweight management. Our clinical model is tech... ...Summary The Nurse Care Coordinator Manager (RN) is an integral member of Clarity... .... Note this is a fully remote position. Key...Remote workFull time
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