Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote RN Care Manager UM/Case Management Leader

Highmark Health

Highmark Health is seeking a full-time remote Care Management Specialist who can work weekends (Saturday and Sunday) and three weekdays. The role focuses on utilization management, reviewing care appropriateness, applying criteria, and identifying opportunities for referral to Health Coaching or care management.

You will monitor the delivery of health care services, educate providers and members, analyze data to improve provider performance and member satisfaction, and respond to inquiries with

#J-18808-Ljbffr
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Remote RN Care Manager UM/Case Management Leader in United States vacancy
  •  ...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 work
    Flexible hours

    Healthcare Support Staffing

    Newark, NJ
    1 day ago
  •  ...Summary: The Team Leader is responsible...  ...of staff UM RNs to ensure coordination...  ...utilization management, patient...  ...expected that all RN Clinical Nurses...  ...compliance. Unlike remote roles, this position...  ...to discuss cases where documentation...  ...current level of care.o Medical Provider... 
    Remote work
    Full time
    Immediate start
    Shift work

    Wellstar Health Systems, Inc.

    Marietta, GA
    more than 2 months ago
  •  ...Summary: The Team Leader is responsible...  ...of staff UM RNs to ensure coordination...  ...utilization management, patient advocacy...  ...that all RN Clinical Nurses...  ...compliance. Unlike remote roles, this position...  ...providers to discuss cases where...  ...current level of care. o Medical Provider... 
    Remote work
    Immediate start
    Shift work

    Wellstar Health Systems, Inc.

    Marietta, GA
    8 hours ago
  • $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 (...  .... This role supports Medicare members through telephonic case management and transition-of-care functions, with no current... 
    Remote work
    Hourly pay
    Work experience placement
    Work at office
    Local area
    Night shift
    Weekend work

    Molina Healthcare

    Vancouver, WA
    23 hours ago
  •  ...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 work
    Work from home

    CVS Health

    United States
    2 days ago
  •  ...Molina Healthcare is seeking a remote RN Care Manager to support Medicare members via telephonic case management and care coordination in a Pacific Time zone context. This role emphasizes no travel, with optional Washington state preference, and requires strong collaboration... 
    Remote work

    Molina Healthcare

    Los Lunas, NM
    3 days ago
  •  ...Integrated Home Care Services (IHCS) is seeking a Clinical Care...  ...Coordination Supervisor to oversee the UM team, ensure regulatory...  ...ensure efficient utilization management and high-quality care. Ideal candidates...  ...degree, 3–5 years in UM or case management, and at least 2... 
    Remote work

    Integrated Home Brand

    Tallahassee, FL
    2 days ago
  •  ...leading health company, is seeking a Case Management Coordinator to support members by coordinating care and assisting with scheduling,...  ...requires an Illinois-resident RN with 3–5 years clinical...  ...Illinois, and comfort working remotely with secure home office setup.... 
    Remote work
    Work from home
    Home office

    CVS Health

    United States
    4 days ago
  •  ...Highmark Inc. is seeking a full-time remote care manager in California to support utilization management across weekends and weekdays.The role...  ...optimize resource use, coordinates with Health Coaching and case management, and helps improve provider and member satisfaction... 
    Remote work
    Full time
    Weekend work
    Weekday work

    Highmark Health

    Sacramento, CA
    3 days ago
  •  ...Highmark Health is seeking a full-time remote RN Care Manager with weekend availability (Saturday and Sunday) and three weekdays, to review care...  ..., and identify opportunities for Health Coaching and case management. The role monitors care delivery, educates providers... 
    Remote work
    Full time
    Weekend work
    Weekday work

    Highmark Health

    United States
    3 days ago
  •  ...Centene Corporation in North Carolina is seeking a Care Manager to provide complex, high-risk pediatric care...  ...resource connections. The role requires an active RN license and residency in North Carolina; it's a remote position with flexible work options. You will... 
    Remote work
    Flexible hours

    Centene Corporation

    Clayton, NC
    1 day ago
  • $68.4k - $105.9k

     ...Highmark Health is seeking a remote Care Management professional to implement utilization review processes and improve member outcomes. The role...  ...driven approach to enhance care quality, with pay range $68,400.00–$105,900.00 and RN licensure requirements.J-18808-Ljbffr... 
    Remote work
    Weekend work
    Weekday work

    Highmark Health

    Clayton, NC
    2 days ago
  • $68.4k

     ...This is a full-time REMOTE position requiring...  ...effective utilization management strategies...  ...appropriateness of health care services,...  ...to a Health Coach/case management, and identification...  ...~3 years RN experience ~ RN Case...  ...~ Experience in UM/CM/QA/Managed Care... 
    Remote work
    Full time
    For contractors
    Work at office
    Local area
    Flexible hours
    Weekend work
    Weekday work

    Highmark Health

    Clifton, TX
    3 days ago
  • $57.79k - $110.39k

     ...team! We are currently hiring for an RN Concierge Care Manager to join BlueCross BlueShield of South...  ...complex, high-touch concierge case management for members identified into...  ...8:00am-5:00pm EST and will be fully remote. The candidate will be required to work... 
    Remote work
    Full time
    Contract work
    For contractors
    Work experience placement
    Currently hiring
    Work at office
    Local area
    Immediate start
    Work from home
    Home office
    Monday to Friday
    Afternoon shift

    BlueCross BlueShield of South Carolina

    South Carolina
    5 days ago
  • Highmark Health is seeking a Remote Nurse Care Manager to implement utilization management strategies across care settings. The role requires weekend...  ..., and coordinating referrals to Health Coaching and case management. The position emphasizes engaging with providers... 
    Remote job
    Weekend work
    Weekday work

    Highmark Health

    Brooklyn, NY
    4 days ago
  • $97.76k - $104k

     ...implement, and standardize UM/UR workflows, best...  ...mentorship to hospital Care Coordination/UR staff,...  ...Collaborate with physicians, case management, and hospital...  ...This job operates in a remote home office environment...  ...unrestricted Registered Nurse (RN) license. · 3-5 years... 
    Remote work
    Full time
    Work at office
    Home office
    Monday to Friday
    Weekend work

    Omega Healthcare Solutions

    Remote
    8 days ago
  • Providence Swedish is seeking a Case Manager RN to evaluate and manage the evolving health and service needs of patients within the CHAT/ACO...  ...patient’s PCP and health team to craft and implement a written care plan within documented time frames. Join a team where best-in-... 

    Providence Swedish

    Seattle, WA
    3 days ago
  • $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 job
    Hourly pay
    Work experience placement
    Work at office
    Local area
    Night shift
    Weekend work

    Molina Healthcare

    Phoenix, AZ
    5 days ago
  •  ...CVS Health, including the Aetna team, seeks a Case Management Coordinator to support members with scheduling, benefits access and education, using care management tools. You will collaborate with members, providers and community partners to improve health outcomes while... 
    Remote work
    Work from home

    4004 Aetna Medicaid Administrators

    United States
    1 day ago
  •  ...CVS Health is seeking a Remote RN Case Manager for its Costco Team. This full-time, work-from-home role focuses on assessments, care planning, and coordination to improve members’ health outcomes. You’ll conduct telephonic and occasional in-person assessments, develop... 
    Remote work
    Full time
    Work from home

    CVS Health

    United States
    2 days ago
  •  ...CVS Health is seeking a dedicated RN Case Manager in Massachusetts to coordinate comprehensive care for members, develop care plans, and communicate with providers...  ...efficient service utilization within a home-based/remote framework. This position requires MA RN licensure... 
    Remote work
    Work from home

    CVS Health

    United States
    2 days ago
  •  ...Highmark Health is seeking a skilled Case Manager to deliver comprehensive care coordination for high-need members. You will assess needs, develop and implement complex care plans, coordinate services, and monitor progress to promote quality and cost-effective outcomes... 
    Remote work

    Highmark Health

    Guin, AL
    1 day ago
  •  ...CVS Health is seeking a Case Manager - Registered Nurse (RN) for a fully remote role within the National Medical Excellence (NME) team. The RN will conduct telephonic...  ...has an active compact RN license, 5 years of RN practice, 2+ years in critical care, and atJ-18808-Ljbffr... 
    Remote work

    CVS Health

    Guin, AL
    3 days ago
  •  ...Sedgwick is seeking a Telephonic Case Manager to collaborate with injured workers, employers...  ...to work through advocacy and coordinated care. Ideal candidates have clinical or rehabilitation...  ...collaborative environment, and can work remotely with flexibility and autonomy while... 
    Remote work

    Sedgwick

    United States
    5 days ago
  •  ...Devoted Health is seeking an experienced RN for telephonic, post-discharge care management of high-risk patients. You will advocate for patients, coordinate interdisciplinary care, and ensure resources and support to improve health outcomes. Ideal candidates are compassionate... 
    Remote work

    Devoted Health

    United States
    2 days ago
  •  ...Optum UT is seeking a RN Case Manager - ED to join our team in Draper, UT. This role delivers telephonic proactive case management to high-risk ED utilizers, coordinating care across providers, caregivers, and community resources. You will assess clinical, behavioral... 
    Remote work

    Optum

    United States
    3 days ago
  •  ...Highmark Health is seeking a Case Manager to deliver comprehensive case management services, develop care plans, and coordinate services...  ...team. The position requires RN licensure (or multi-state eNLC...  ...months of hire, with potential remote work and up to 25% travel.... 
    Remote work

    Highmark Health

    United States
    3 days ago
  •  ...Highmark Inc. is recruiting a Case Manager RN for remote work across PA, MD, WA, NC and LA. The role focuses on comprehensive case management, coordinating...  ...or equivalent multi-state licensure. Strong assessment, care planning and collaboration skills are essential for... 
    Remote work

    Highmark Health

    United States
    3 days ago
  •  ...Highmark Inc. is seeking a full-time remote Care Management professional with weekend availability to implement care management reviews and improve...  ..., educate providers, and coordinate with Health Coaches and case management, while adhering to privacy laws and regulatory... 
    Remote work
    Full time
    Weekend work

    Highmark Health

    Provo, UT
    3 days ago
  •  ...Benefis Hospitals Inc is seeking a full-time Community Care Nurse Case Manager in Bozeman, MT. This role involves providing home and community-...  ...candidates will have at least three years of nursing experience, an RN license, and a knowledge of case management practices. The... 
    Remote work
    Full time
    Work from home

    Benefis Health System

    Bozeman, MT
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote RN Care Manager UM/Case Management Leader. Be the first to apply!