Remote RN Care Manager - Utilization & Care Coordination
Highmark Health Company
- Remote job
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. The role involves applying clinical criteria to ensure appropriate resource use, identifying referrals to Health Coaching and case management, and resolving quality issues. Required RN licensure (PA or multi-state via eNLC) and ~3 years of clinical experience in care management or a related field. #J-18808-Ljbffr Highmark Health Company
- 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 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...Remote jobFull timeWeekend workWeekday work
- Highmark Inc. is seeking a full-time remote Health Care Manager to implement effective utilization management strategies, review care appropriateness, and identify opportunities for Health Coach/case management referrals. This role requires weekend availability (Saturday...Remote jobFull timeWeekend workWeekday work
- Highmark Health is seeking a full-time remote RN Care Manager to implement utilization management strategies and oversee care management reviews. The role includes collaborating with providers, coaching members, and improving provider and member satisfaction. Weekend availability...Remote jobFull timeShift workWeekend workWeekday work
$113.73k - $170.46k
...patients receive high-quality care while efficiently utilizing medical resources. Reviews... ...~ Registered Nurse (RN) licensure in the state of... ...variances to the on-site care management teams when appropriate.... ...stakeholders to ensure a coordinated and efficient care process...Remote workFull timeWork experience placement- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication... ...team, handling post-acute care services including SNF, Home... ...right setting. This remote role requires US RN licensure in the state of...Remote workWork from home
- ...Humana Inc. seeks a Utilization Management RN to interpret clinical data and support coordination, documentation and communication of medical... ...ensure appropriate post-acute care in the right setting.... ...knowledge of care criteria, and a remote, metrics-focused #J-18808-LjbffrRemote workWork from home
- Highmark Inc. is seeking a Remote Care Manager with full-time commitment, weekend... .... You will implement utilization management strategies, review... ...appropriateness of care, and coordinate with Health Coaching and case... ...member outcomes. Requires RN licensure, 3 years of clinical...Remote jobFull timeWeekend workWeekday work
- Highmark Inc. is seeking a full-time remote care manager in California to support utilization management across weekends and weekdays. The role reviews care... ...appropriateness, applies criteria to optimize resource use, coordinates with Health Coaching and case management, and...Remote jobFull timeWeekend workWeekday work
- 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
- Highmark Inc. is seeking a full-time REMOTE Care Management professional with weekend availability to coordinate utilization management and health coaching. You will review services... ...3 years of progressive clinical experience; RN licensure in PA or multi-state licensure,...Remote jobFull timeWeekend work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care (SNF, Home Health, DME). The role reports to the Manager of Utilization Management and is part of the One Home/Home Solutions...Remote work
- ...Humana Inc. is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of... ...Management and support post-acute care services across SNF, home... ...role requires an active compact RN license, over one year of RN...Remote work
- ...Humana is seeking an Utilization Management Registered Nurse to interpret and support coordination, documentation and communication... ...and help deliver coordinated care for members in a remote/post-acute care setting.The role requires an active RN license in your state, 1+...Remote work
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations... .... The role supports post-acute care—SNF, home health, and DME—while... ...nursing experience in a fully remote, metrics-driven environment. A...Remote work
- ...Humana seeks an experienced Utilization Management RN to interpret and support coordination, documentation and communication of... ...benefit determinations for post-acute care. You will work with providers... ..., and a BSN or related degree. Remote work eligible. #J-18808-Ljbffr...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
- ...Humana is seeking a Utilization Management Registered Nurse to interpret and support medical... ...benefit determinations. You will coordinate with physicians and care teams to ensure appropriate care levels... ...treatment. The role emphasizes remote work, prior utilization management...Remote work
$41.71 - $105.65 per hour
...RN Care Coordinator (Case Manager) BWH Care Continuum Mass General Brigham relies on a wide range of professionals... ...an interdisciplinary team, the RNCC utilizes patient assessment, care guidelines,... ...Shift: 40hr variable rotation Remote Type Onsite Work Location 45...Remote workHourly payWork at officeFlexible hoursShift work$26.01 - $68.55 per hour
...Health is seeking a Registered Nurse (RN) for Utilization Management. You will review clinical... ...determinations, apply guidelines, and coordinate care with providers to ensure appropriate care. This full-time role offers remote work from home in the United States,...Remote jobHourly payFull timeWork from home- ...Clarity Pediatrics, Inc. is seeking a Nurse Care Coordinator Manager (RN) to lead a multidisciplinary team in delivering pediatric chronic care... ...conditions like ADHD, obesity, and related needs. This fully remote role supervises nurses, MAs, and community health workers...Remote work
- CVS Health seeks a Registered Nurse (RN) for Utilization Management to ensure appropriate care through clinical review and coordination. You will review information, apply guidelines, and collaborate with providers to support optimal patient outcomes. Ideal candidates...Remote jobFlexible hours
- Humana is seeking an Utilization Management Nurse 2 to coordinate, document, and communicate medical services and benefit determinations. The role requires... ...-making, and strong telephonic communication in a remote setting. The candidate will interpret clinical data to...Remote job
- ...DescriptionJob SummaryRN - Care CoordinatorTalented... ...- Travel: Care Manager RNMust be willing to float... ...care through effective utilization and monitoring of healthcare... .... The Care Manager coordinates care and services... ...(Y or N): YIs this a remote position? (Y or N): NClinical...Remote workTemporary workWork at officeWeekend work
- ...experienced Registered Nurse (RN) to join our Utilization Management team. You will help... ...members receive the right care at the right time through... ...clinical review and care coordination. Active RN license and 2+... ...weekends, and holidays, in a remote-capable environment...Remote jobFlexible hoursAfternoon shift
$71.1k - $97.8k
...Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who will assess and... .... Highlights Location: Remote, IN Schedule: Full-time, Monday... ...eligible for Medicare. Utilize various strategies to... ...Licensed Registered Nurse (RN) in the state of Indiana without...Remote workFull timeTemporary workWork from homeRelocation packageMonday to Friday- 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
- ...Description Join our team as a remote (Oklahoma City) full time days and every other weekend RN Case Manager -Utilization Review at INTEGRIS Health,... ...available resources. Recommends and coordinates timely transfers to appropriate levels of care as indicated by clinical needs...Remote workFull timeWork at officeWeekend work
$85.7k - $129.31k
...Job Description: The RN Utilization Review Care Management I leverages clinical expertise and critical thinking to perform utilization review care management... .... Experience working successfully working in a remote environment or using Advanced Microsoft Suite, including...Remote workHourly payReliefWork at officeFlexible hoursShift workWeekend work2 days per week- ## RN - Care CoordinatorApply: Ridgeland, MS: Full time:... ...Clinical Operations, and Remote Patient Monitoring##... ...Telehealth## Job Title:RN - Care Coordinator## Job Summary:To support disease management tasks which include... ...with chronic disease, utilization review and/or quality...Remote workFull timeWork experience placementCasual workShift work
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