NewTravel Nurse RN - Utilization Review - $1,890 per week VyTalent SolutionsTravel Nurse RN - Utilization Review - $1,890 per weekIndependence, MOBuilt on more than three decades of experience, VyTalent Solutions partners with hospitals, surgical centers, behavioral health facilities, schools, correctional healthcare environments, and community-based organizations nationwide. Whether you're looking for travel, local, PRN, or permanent opportunities, we're here to connect you with meaningful work where you can make an impact in patient and student care.
NewTravel Nurse RN - Case Management - $2,136 per week MedPro Healthcare StaffingTravel Nurse RN - Case Management - $2,136 per weekBranson, MOWork is administered in a variety of settings, including HMOs, community health organizations, long-term care facilities, behavioral health programs, rehabilitation centers, schools, and case management companies. MedPro Healthcare Staffing , a Joint Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse (RN) for a travel assignment with one of our top healthcare clients.
NewHouse Supervisor RN - $36-56 per hour BJC HealthCareHouse Supervisor RN - $36-56 per hourSaint Louis, MO$36–$56 / hourBarnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Step into a high-impact House Supervisor role at Barnes-Jewish Hospital, part of BJC HealthCare, where you will support hospital-wide operations and patient care across both the main campus and North Campus.
NewRapid Response RN - $32-48 per hour BJC HealthCareRapid Response RN - $32-48 per hourSaint Louis, MOThis highly autonomous role partners with bedside nurses, physicians, and interdisciplinary teams to assess patient deterioration, respond to rapid response and difficult airway events, facilitate escalation of care, and help ensure patients receive timely interventions when clinical conditions change. Team members are frequently called upon to serve as a second set of eyes, helping validate concerns, coordinate resources, and support complex clinical decision-making for patients requiring a higher level of care.
NewRN Care Manager II-IPCM - Days - PRN MercyRN Care Manager II-IPCM - Days - PRNSpringfield, MOThe Care Management model provides effective transition planning and length of stay oversight to maintain patient experience, safety, and quality of care utilizing performance metrics and adoption of best practices. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
NewRN Care Manager Weekend MercyRN Care Manager WeekendJoplin, MOThe Care Management model provides effective transition planning and length of stay oversight while encompassing quality patient care, patient safety, and financial components; promotes integration of a seamless care model; coordinates patient throughput; encourages healthcare team collaboration and coordination as evidenced by metrics; and optimizes performance and adoption of best practice. Additionally, this is a key role in advocating for patients' needs, promoting health education, and facilitating smooth transitions of care across healthcare settings.
NewRN Care Manager II-IPCM - Onsite Mercy Hospital STL MercyRN Care Manager II-IPCM - Onsite Mercy Hospital STLSaint Louis, MOThe RN Care Manager II - IPCM, as part of the interdisciplinary team, assesses, plans, advocates, and coordinates care from admission to discharge ensuring a safe transition post-hospitalization. Additionally, this is a key role in advocating for patients' needs, promoting health education, and facilitating smooth transitions of care across healthcare settings.
NewRN Care Manager - Part Time, Days MercyRN Care Manager - Part Time, DaysLebanon, MOThe Care Management model provides effective transition planning and length of stay oversight to maintain patient experience, safety, and quality of care utilizing performance metrics and adoption of best practices. The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates care from admission to discharge ensuring a safe transition post hospitalization.
RN - Case Manager SSM HealthRN - Case ManagerSaint Louis, MOApplies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department‘s Scope of Service. May also be responsible for: utilization management process, ED case management process, admission process, and act as a case manager liaison with post acute providers (skilled nursing facilities, rehab, home health, etc.).
NewRN Care Manager II-IPCM/FT/Mercy Hospital STL MercyRN Care Manager II-IPCM/FT/Mercy Hospital STLSaint Louis, MOThe Care Management model provides effective transition planning and length of stay oversight to maintain patient experience, safety, and quality of care utilizing performance metrics and adoption of best practices. The Care Manager, as part of the interdisciplinary team, assess, plans, advocates, and coordinates care from admission to discharge ensuring a safe transition post hospitalization.
NewRN - Nurse Navigator-Specialty MercyRN - Nurse Navigator-SpecialtyWashington, MOThis position is designed to facilitate an effective process of the new care model; supporting quality patient care, safety, and financial components; promoting integration of a seamless care model; coordinating patient discharge planning for post-acute services, length of stay (LOS) management and utilization management; collaborating to include coordination as evidenced by metrics, optimizing performance and adoption of best practice. This role coordinates patient care, provides education and support, helps with discharge planning, and works closely with physicians, nurses, and other healthcare team members to ensure excellent patient outcomes.
NewRegistered Nurse - Case Manager SSM HealthRegistered Nurse - Case ManagerLake Saint Louis, MOApplies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's Scope of Service. May also be responsible for: utilization management process, ED case management process, admission process, and act as a case manager liaison with post acute providers (skilled nursing facilities, rehab, home health, etc.).
NewRN - Clinical Supervisor - GI Lab - Full Time - Days MercyRN - Clinical Supervisor - GI Lab - Full Time - DaysWashington, MOThis role oversees daily operations, staffing, patient flow, quality initiatives, and staff development while collaborating with physicians, leadership, and multidisciplinary teams to achieve exceptional patient outcomes. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
NewNurse Manager 7B Medical Telemetry MercyNurse Manager 7B Medical TelemetrySpringfield, MOEffectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies a vision and goals congruent with the Medical Center and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safe and quality clinical outcomes, financial performance and physician satisfaction. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
NewNurse Manager - Main Operating Room MercyNurse Manager - Main Operating RoomSaint Louis, MOEffectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies a vision and goals congruent with the Medical Center and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safe and quality clinical outcomes, financial performance and physician satisfaction. The Nurse Manager provides 24-hour leadership and accountability for the Main Operating Room, ensuring the delivery of safe, high-quality patient care while driving operational excellence, staff engagement, and clinical outcomes.
NewNurse Manager - GI Lab MercyNurse Manager - GI LabCape Girardeau, MOResponsible for assisting the Chief Nursing Officer in the delivery of safe, quality and cost efficient care by having competent staff members in the Med Surg and Outpatient Departments. Works collaboratively and effectively with other administrative personnel, physicians and staff from other areas throughout the Hospital to enhance communication, share pertinent data and improve processes across the continum.
NewRN Care Manager - Part Time, Weekend Option MercyRN Care Manager - Part Time, Weekend OptionLebanon, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. The Care Manager facilitates transition of care planning with an interdisciplinary healthcare team to achieve quality outcomes, reduce costs and ensure patient safety.
NewRegistered Nurse - First Assist Lead SSM HealthRegistered Nurse - First Assist LeadBridgeton, MOResponsible for implementing and managing all aspects of operating room related to a designated specialty for clinical and administrative processes, including development and implementation of clinical and programmatic policies and procedures, input into operational and educational budgets, education and training and process improvement. Provides cost effective services through recommended changes in practice that increase efficiency and minimizes waste, appropriate use/handling of supplies, equipment and instruments, decreasing turnover time for better utilization, and minimizing overtime.
NewClinical Supervisor RN 4A Cardiac Med Intermediate MercyClinical Supervisor RN 4A Cardiac Med IntermediateSpringfield, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. Clinical Supervisor encourages the heart of co-workers by providing both public and private recognition and connecting on a personal level with those they serve through servant leadership.
NewPart Time RN Care Manager-Weekend MercyPart Time RN Care Manager-WeekendJoplin, MOThe Care Management model provides effective transition planning and length of stay oversight while encompassing quality patient care, patient safety, and financial components; promotes integration of a seamless care model; coordinates patient throughput; encourages healthcare team collaboration and coordination as evidenced by metrics; and optimizes performance and adoption of best practice. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
NewRN- Clinical Supervisor, FT Days WEO MercyRN- Clinical Supervisor, FT Days WEOSt. Louis, MOParticipates in the supervision of unit operations by performing delegated duties such as development of staffing schedules, planning of unit inservices, conducting staff meetings, developing budget and departmental activity reports, and setting overall departmental goals and objectives. See Mercy Terms & Conditions at https://www.mercy.net/about/legal-notices/ and Privacy Policy at https://www.mercy.net/about/legal-notices/ and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
NewRN - Nurse Manager - Surgical Intensive Care Unit MercyRN - Nurse Manager - Surgical Intensive Care UnitSaint Louis, MOEffectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies a vision and goals congruent with the Medical Center and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safe and quality clinical outcomes, financial performance and physician satisfaction. We’re looking for a Nurse Manager to lead our Surgical ICU team —a high-impact unit where clinical excellence and teamwork come together to deliver exceptional patient care.
Clinical Pharmacist-Hospital - $10K Sign-on Bonus MercyClinical Pharmacist-Hospital - $10K Sign-on BonusSpringfield, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. This role serves as a key drug information resource for physicians, nurses, and patients while supporting high-quality patient care.
NewClinical Pharmacist-Hospital Overnights 7 on/7 off - $10K Sign-on Bonus MercyClinical Pharmacist-Hospital Overnights 7 on/7 off - $10K Sign-on BonusSpringfield, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. This role serves as a key drug information resource for physicians, nurses, and patients while supporting high-quality patient care.
NewClinical Pharmacist MercyClinical PharmacistLebanon, MOYou'll have the opportunity to collaborate with highly skilled healthcare professionals, influence patient outcomes, mentor future pharmacists, and contribute to innovative pharmacy practice in a supportive and rewarding environment. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
Clinical Pharmacist - Full Time MercyClinical Pharmacist - Full TimeJoplin, MOIf you are a clinically driven pharmacist who thrives in a collaborative healthcare environment and is passionate about improving patient outcomes, we encourage you to apply and become an integral part of our patient care team. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
Behavioral Health Consultant Compass Health NetworkBehavioral Health ConsultantLebanon, MissouriFull timeThis is a great opportunity for someone who enjoys collaborative care, thrives on variety in their work, and is passionate about improving health outcomes through behavioral interventions and patient support. Provide in-person and remote consultation to patients and primary care providers on a range of health concerns, including mental health, chronic conditions, and wellness management.
NewClinical Supervisor CVICU 3E Days MercyClinical Supervisor CVICU 3E DaysSpringfield, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. Clinical Supervisor works collaboratively and effectively with other administrative personnel, physicians and co-workers to communicate and improve processes across the continuum.
NewClinical Supervisor CVICU 3E Nights MercyClinical Supervisor CVICU 3E NightsSpringfield, MOFrom day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. Clinical Supervisor works collaboratively and effectively with other administrative personnel, physicians and co-workers to communicate and improve processes across the continuum.
NewManager-Nursing Lvl 2 - Cardiothoracic / Vascular Operating Room MercyManager-Nursing Lvl 2 - Cardiothoracic / Vascular Operating RoomSaint Louis, MOEffectively managing the delivery of nursing care requires creating and promoting a professional practice environment at the unit level that exemplifies a vision and goals congruent with the Medical Center and the respective clinical service line as well as high levels of coworker engagement, patient satisfaction, safe and quality clinical outcomes, financial performance and physician satisfaction. From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.
NewUtilization Management Nurse Consultant CVS Health CorpUtilization Management Nurse ConsultantMO$26.01–$62.32 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. 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.
Utilization Management Nurse Consultant - Medical Review (Remote) CVS Health CorpUtilization Management Nurse Consultant - Medical Review (Remote)MORemote$26.01–$56.14 / hourAs a Utilization Management (UM) Nurse Consultant specializing in Medical Review, you'll play a vital role in ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. Actively cross-trains to perform reviews of multiple case types to provide a flexible workforce to meet client needs.
RN, Utilization Case Manager Archimedes Navitus Health Solutions LLCRN, Utilization Case Manager ArchimedesMOFounded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit - alignment, value and transparency - Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. The RN, Utilization Case Manager will coordinate care between physicians, patients, and pharmacies, facilitating access to specialty medications for patients with complex disease states.
RN, Utilization Case Manager - Archimedes Navitus Health Solutions, LLCRN, Utilization Case Manager - ArchimedesEarth City, MissouriFull timeFounded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit – alignment, value and transparency – Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. M-F 8am to 5pm): Our Core Business Hours- Hybrid 3 Days in Office Overview: The RN, Utilization Case Manager will coordinate care between physicians, patients, and pharmacies, facilitating access to specialty medications for patients with complex disease states.
Utilization Management Clinician (Tuesday - Saturday) PacificSource Health PlansUtilization Management Clinician (Tuesday - Saturday)MO$70,950–$106,424.99 / yearEducation, Certificates, Licenses: Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Psychiatric Mental Health Nurse Practitioner, (PMHNP) credential required. Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions.
NewUtilization Management Clinician (Tuesday - Saturday) PacificSourceUtilization Management Clinician (Tuesday - Saturday)MissouriEducation, Certificates, Licenses: Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Psychiatric Mental Health Nurse Practitioner, (PMHNP) credential required. Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions.
Utilization Management Behavioral Health Professional Humana IncUtilization Management Behavioral Health ProfessionalMORemote$65,000–$88,600 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Humana Healthy Horizons in Kentucky is looking for a Utilization Management Behavioral Health Professional 2 who uses behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.
Director, Utilization Management Hospice CoE Centene Corporation GroupDirector, Utilization Management Hospice CoEMO$133,700–$247,400 / yearThe Director, Utilization Management Hospice CoE is accountable for the enterprise strategy, clinical governance, and operational execution of hospice and palliative care identification, referral, and utilization management across Medicaid and Marketplace populations. Executes the overall strategy for onboarding, hiring, and training new utilization management team members to ensure adequate training and high quality-care to improve member and provider experience and ensure compliance.
NewRN-Utilization Review SSM HealthRN-Utilization ReviewMissouriApplies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's scope of service. Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
Utilization Review Coordinator Freeman Health SystemUtilization Review CoordinatorJoplin, MOProvide Utilization Review and Case Management to the Emergency Department population who present with social and or discharge needs which may prevent them from returning to their current environment. If LPN, current Missouri Practical Nurse license or current Practical Nurse license from a compact state.
Revenue Cycle Medical Billing Resource Utilization Clinical Auditor Global Medical Response IncRevenue Cycle Medical Billing Resource Utilization Clinical AuditorWest Plains, MORemoteGMR's Core Behaviors-keep care at the center, raise your hand, seek to understand, find a way together and be accountable-unite our teams and set us apart in emergency medical services. Work with the Appeal team to determine the best approach to each clinical denial in order to maximize claim reimbursement and minimize the financial risk to patients and GMR.
Utilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerKansas City, MORemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
Manager, Telephonic Nurse Case Management Panera Bread CompanyManager, Telephonic Nurse Case ManagementFenton, MORemote$87,753–$103,239 / yearThe Nurse Case Manager works collaboratively with treating physicians, the Third Party Administrator (TPA), adjusters, legal counsel, managers, and HR to ensure claims progress efficiently, medical costs are appropriate, and injured employees are supported throughout recovery. The Nurse Case Manager serves as the clinical resource within the Risk Management & Safety team, providing telephonic nurse case management to support injured employees through the workers' compensation process from initial injury through return to work.
Nurse Practitioner (NP) - In Person - Columbia/Jefferson City, Missouri MTC CareNurse Practitioner (NP) - In Person - Columbia/Jefferson City, MissouriColumbia, MOOur clinical team includes trained psychiatry and psychology providers with a focus on tailored interventions to ensure quality of life for patients, a supportive environment that promotes mental well-being, interdisciplinary collaboration, and compliance with regulatory organizations. Advance your career to a whole new level providing much-needed healthcare services to underserved communities as a Nurse Practitioner (NP) with MTC Care, the nation's largest telehealth company!
LPN Admissions Coordinator (weekends only) National HealthCare CorpLPN Admissions Coordinator (weekends only)Osage Beach, MOPatient care services will be provided by a multidisciplinary treatment team of professionals utilizing current, research-based, Best Practice protocols designed to achieve maximum therapeutic benefit for each patient entrusted to its care. We would like for you to consider our Intake Specialist opportunity for our state of the art hospital and carry out our vision of bringing communities, healthcare providers, and families together to improve behavioral health, one patient at a time.
RN Case Manager, PRN - Barnes Jewish West County Hospital BJC HealthCareRN Case Manager, PRN - Barnes Jewish West County HospitalSaint Louis, MOWith 64 private patient rooms, 14 operating rooms and four intensive care unit rooms, the facility was designed to provide a comforting environment that is innovative, efficient and centered on the patient experience. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to obtain optimum value for the patient and the reimbursement source.
Psychiatric Mental Health Nurse Practitioner (PMHNP) - In Person - Columbia/Jefferson City, Missouri MTC CarePsychiatric Mental Health Nurse Practitioner (PMHNP) - In Person - Columbia/Jefferson City, MissouriColumbia, MOOur clinical team includes trained psychiatry and psychology providers with a focus on tailored interventions to ensure quality of life for patients, a supportive environment that promotes mental well-being, interdisciplinary collaboration, and compliance with regulatory organizations. Advance your career to a whole new level providing much-needed healthcare services to underserved communities as a Psychiatric Mental Health Nurse Practitioner (PMHNP) with MTC Care, the nation's largest telehealth company!
Registered Nurse Clinical Manager Humana IncRegistered Nurse Clinical ManagerIndependence, MORemote$77,200–$106,200 / yearOur care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients.
REGISTERED NURSE, ER NIGHTS Community Hospital-FairfaxREGISTERED NURSE, ER NIGHTSFairfax, MOThis position requires intermittent physical activity, including standing, walking, bending, kneeling, stooping, and crouching as well as lifting and supporting patients. Administers and preforms nursing assessment in accordance with the applicable patient type which my include: Medical, Surgical, Obstetrical, Newborn, Pediatric, and or Telemetry/cardiac patient.
REGISTERED NURSE - NIGHTS Community Hospital-FairfaxREGISTERED NURSE - NIGHTSFairfax, MOThis position requires intermittent physical activity, including standing, walking, bending, kneeling, stooping, and crouching as well as lifting and supporting patients. Provides and performs oversight, delegation, and coordination of total nursing care with other health care providers to meet holistic care needs of patients.