Remote RN Care Manager: Utilization & Case Management
Highmark Health
- Remote job
Highmark Health is seeking a Remote Nurse Care Manager to implement utilization management strategies across care settings. The role requires weekend availability (Saturday and Sunday) plus three weekdays, with a focus on reviewing care appropriateness, applying criteria, and coordinating referrals to Health Coaching and case management. The position emphasizes engaging with providers and members, analyzing data, and driving quality improvements while maintaining privacy and compliance with #J-18808-Ljbffr Highmark Health
- 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
$113.59k - $191.84k
...Care Manager RN- REMOTE position. This position is Full time and will work 8- hour, Day shifts.... ...responsible for carrying out effective case management functions for identified patients... ...resources to ensure the appropriate utilization of resources according to clinical and...Remote workMinimum wageFull timeLocal areaShift workDay shift- Highmark Inc. seeks a full-time registered nurse for a remote role requiring weekend availability and three weekdays. You will lead utilization management and coordinate care through health coaching and case management interventions. Responsibilities include applying criteria...Remote jobFull timeWeekend workWeekday work
- ...Molina Healthcare is hiring a remote RN Care Manager for our Washington State Health Plan. This role is remote, however there is a preference... .... This role supports Medicare members through telephonic case management and transition-of-care functions, with no current...Remote workFull timeWork at officeLocal areaNight shiftWeekend work
- ...Remote Full Time Days And Every Other Weekend RN Case Manager -Utilization ReviewJoin our team as a remote full time days and every other weekend RN Case Manager -Utilization... ...:Experience with managed care and payer/provider requirementsEDUCATION:Bachelor...Remote workFull timeWork at officeShift workWeekend 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 RN with utilization management expertise for a remote role requiring weekend... ...The position focuses on reviewing care appropriateness, applying criteria... ...and coordinating with Health Coach/case management to improve member outcomes...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... ...referrals to Health Coaching and case management, and resolving quality issues. Required RN licensure (PA or multi-state via eNLC...Remote jobFull timeWeekend workWeekday work
- CVS Health Corporation is seeking a Case Management Coordinator in Illinois to support members with scheduling, benefits access, and education using care management tools. The role emphasizes critical thinking, collaboration with providers, and patient-centered care to...Remote jobWork from home
- ...United States is seeking a full-time RN care manager for a remote position requiring weekend availability... ...three weekdays. The role focuses on utilization management, reviewing care... ...guiding referrals to Health Coaching and case management. Responsibilities include...Remote jobFull timeWeekend workWeekday work
- CVS Health is seeking a Case Manager - Registered Nurse (RN) for a fully remote role within the National Medical Excellence... ...role covers Case Management and Utilization Management. The ideal candidate... ...practice, 2+ years in critical care, and at #J-18808-Ljbffr CVS...Remote job
- Molina Healthcare is seeking a remote RN Care Manager. The role prefers candidates in Washington State and aligns with Pacific Standard Time hours. You will support Medicare members via telephonic case management and transition-of-care tasks, with no nighttime shifts or...Remote jobShift workNight shift
- Job Title : Registered Nurse (RN) Disease Manager Job Overview : The Registered... ...responsible for coordinating care and managing the health... ...teams, including physicians, case managers, social workers, and... ...document interactions accurately. Utilize health information technology...Remote job
- OU Health is seeking a Case Manager, RN - Utilization Review (PRN) to evaluate medical necessity and appropriate care, securing authorizations and coordinating with payors, patients, and interdisciplinary teams. This role emphasizes HIPAA compliance and strong communication...Remote jobRelief
- ...Financial Services Inc. is seeking a Telephonic Medical Case Manager, RN, to deliver comprehensive remote case management in Texas. You will drive... ...employees, providers and employers, and may include utilization review and care coordination. The role requires an active RN...Remote job
$26.41 - $59.21 per hour
Molina Healthcare is hiring a remote RN Care Manager for our Washington State Health Plan. This role is remote, however there is a preference (... ...hours. This role supports Medicare members through telephonic case management and transition-of-care functions, with no current...Remote jobHourly payWork experience placementWork at officeLocal areaNight shiftWeekend work$60.2k - $107.4k
Optum Home & Community Care, part of the Optum family of businesses... ...setting. As a Telephonic RN Case Manager, you will serve as a primary... ...the flexibility to work remotely*, preferably in Washington or... ...with assigned care managers, utilization management, market...Remote workMinimum wageFull timeWork experience placementWork at officeLocal areaMonday to Friday- AvonRisk is seeking a Medical Case Management nurse (RN) to ensure maximum medical and disability improvement... ...early intervention and coordinated care for injured workers in California.... ...include triage, pre-authorization, utilization review, and ensuring timely...
- ...NJ seeks a dedicated nurse to coordinate and facilitate patient care within a multidisciplinary team, utilizing resources effectively to support utilization review and case management. The role requires a RN licensed in New Jersey with a Bachelor’s degree; ANCC case...Day shift
- ...of daily living to determine member eligibility for care services. Candidates must have an active RN license in NJ and at least one year of home health experience... ...involve travel across counties in NJ, with flexible remote follow-up work. The company offers a competitive...Remote workFlexible hours
- ...dedicated Registered Nurse to facilitate and manage clinical outcomes in Deerfield Beach,... ...Florida. This position involves coordinating care, evaluating discharge needs, and ensuring... ...shift and emphasizes the importance of utilization management and continuity of care. #J-18...Shift work
$119.14k - $184.95k
...Care Manager RN - REMOTE position. This position is Full time and will work 8- hour, Day shifts. The Care Management Recovery Advocate (CMRA) is... ...an acute hospital setting. ~4 years of Experience as a case manager in an acute hospital setting. Preferred Qualifications...Remote workMinimum wageFull timeLocal areaShift workDay shift- ...registered nurse to coordinate patient care within a multidisciplinary team and oversee utilization of resources. The role focuses on case management and collaboration across care disciplines... ...include a Bachelor's degree and NJ RN licensure, with ANCC case management certification...
$48 per hour
Gateway Regional Medical Center is looking for a Utilization Review Specialist RN to join our Case Management team in Granite City, Illinois. This full-time role is... ...working collaboratively to ensure quality patient care. A comprehensive benefits package is offered including...Full time- ...CVS Health is seeking a Case Manager RN for a 100% remote role. You will assess, plan, coordinate, advocate, and evaluate care to meet members' benefit plans and health needs. Duties include comprehensive assessments, care coordination, discharge planning, and collaboration...Remote work
- ...Arkansas Blue Cross Blue Shield is seeking an RN Case Manager to assess, plan, implement, coordinate, monitor, and evaluate individualized care plans. The role emphasizes quality outcomes and cost-effective care, with potential focus areas such as obstetrics, neonatal...Remote work
- ...CorVel is seeking a Telephonic Case Manager to coordinate resources and develop cost-effective, personalized care plans for ill or injured individuals. This remote role relies on clinical expertise to assess treatment plans and communicate with treating physicians to...Remote work
- GlobalHealth is seeking an experienced RN Case Manager to oversee telephonic case management and... ...members’ health needs. You will coordinate care with providers, educate members and... ...and HIPAA standards. The role supports a remote work environment with state-specific exclusions...Remote work
- ...CorVel Corporation seeks a Telephonic Case Manager to coordinate resources and develop cost-efficient, personalized care plans for ill or injured individuals. This remote role emphasizes clinical assessment and collaboration with physicians to optimize treatment and support...Remote work
- ...CVS Health is hiring a Case Manager RN to provide remote, patient-centered care coordination from home. You will assess, plan, advocate, and monitor cases to meet benefit plan and health needs, with collaboration across care teams and vendors. Strong clinical judgment...Remote work
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