Remote Utilization Management Case Manager

Apploi is seeking an experienced Registered Nurse for an 8-week travel assignment in Utilization Review. The RN will handle clinical investigations, medical record reviews, and non-acute utilization review in a contracted travel role based in New York. The position requires an active NY RN license and AHA BLS certification, with a preference for candidates...

Devoted Health seeks a Supervisor to lead the Utilization Management Coordinators, coaching staff and ensuring timely prior authorization processing while maintaining CMS and Medicare Advantage compliance. You will manage intake, clinical reviews, and P2P scheduling with Medical Directors, drive AI-enabled workflow improvements, and partner with clinical...

Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health...

Curana Health seeks an experienced Utilization Management Nurse to review and monitor members’ use of healthcare services, ensuring high-quality, cost-effective care. The role emphasizes concurrent review, discharge planning, and high-dollar claims analysis, with remote telephonic duties and occasional weekend coverage. The position collaborates with the...

HonorHealth is seeking a remote Utilization Management support specialist in a Day shift to assist with UM tasks, payer communications, and care coordination. The role supports admissions approvals and documentation in EMR/EPIC, with prior clerical and healthcare admin experience preferred. A High School Diploma or GED is required, and an Associates degree...

Humana Inc. is seeking an UM Administration Coordinator to support UM operations through provider and member phone support and back-office administrative duties. This remote role reports to the Supervisor, UM Management and requires 8-hour shifts ending by 7:00 PM CST/8:00 PM EST, with one weekend day and holiday rotation. You will handle prior...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger -...

Imagine a career at one of the nation’s most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News &...

Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs. We’re more than just a team; we're a close-knit community. Our shared commitment to caring for each other and those we serve is what sets us apart. Guided by our unwavering core values: Excellence, Compassion, Curiosity, and Integrity, we...