- CVS Health (Raleigh, NC)
- …and work schedules may include weekends, holidays, and evening hours_ As a Utilization Management Nurse Consultant you will utilize clinical experience ... residence + 3+ years of experience as a Registered Nurse + 1+ year(s) of acute care experience (ex:...include weekends, holidays, and evening hours **Preferred Qualifications** + Prior Authorization or Utilization Management … more
- Humana (Raleigh, NC)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...Critical Care Nursing experience required + Previous experience in utilization management required + Prior … more
- Centene Corporation (Raleigh, NC)
- …key initiatives and to facilitate on-going communication between utilization management team, members, and providers + Monitors prior authorization, ... Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. ... Manager will assume responsibility for daily operations and the management of nursing staff who use elevated level skills...Nursing may have opportunity to become registered as a nurse with a state licensing board prior … more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. ... safety of patients, visitors, and staff. Manages core Quality Management programs to include Survey Readiness, External Peer Review...Nursing may have opportunity to become registered as a nurse with a state licensing board prior … more
- UNC Health Care (Chapel Hill, NC)
- …serve. The individual selected for this position will function as a Neonatal Nurse Practitioner (NNP) delivering critical care medical management in the Newborn ... **Description** Have you considered a Neonatal Nurse Practitioner career with UNC Health? This opportunity...standards. The practitioner has responsibility for complete daily medical management of a caseload of critically ill newborn infants… more
- Actalent (Raleigh, NC)
- Actalent is Hiring a Remote Nurse Coach Job Description As a Nurse Coach, you will utilize your clinical expertise to manage assigned Post-Acute Care patients' ... + Collaborate closely with the Post-Acute Care patient's home health agency nurse and physicians to facilitate education and adherence to established healthcare… more
- Fresenius Medical Center (Cary, NC)
- …direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in optimum ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more
- Intermountain Health (Raleigh, NC)
- …of 2 years' experience in acute clinical nursing setting + Knowledge of utilization management and case management principles preferred KNOWLEDGE, SKILLS, ... **Job Description:** The Pre-Access Prior Authorization RN provides timely review of authorization requests and/or review of denials to ensure medical necessity,… more
- Evolent (Raleigh, NC)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more