• Pre - Authorization Nurse

    Humana (Raleigh, NC)
    **Become a part of our caring community and help us put health first** The Pre - Authorization Nurse 2 reviews prior authorization requests for appropriate ... policies, and approves services or forward requests to the appropriate stakeholder. The Pre - Authorization Nurse 2 + Completes medical necessity and level of… more
    Humana (11/16/24)
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  • Clinical Care Transition Specialist / Registered…

    Option Care Health (Morrisville, NC)
    …effective treatment plan. + Responsible for collecting, reviewing and completing pre -admission information and securing related signoff. + Partners with Account ... performance reviews, discipline, etc.) BASIC EDUCATION AND EXPERIENCE REQUIREMENTS Licensed Registered Nurse (RN) or licensed Pharmacist in the state of practice and… more
    Option Care Health (10/12/24)
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  • Coordinator, Intake Utilization Management

    Evolent Health (Raleigh, NC)
    …this individual also works with our clinical team, which includes our Nurse , Clinical Reviewers and Field Medical Directors. Opportunities to work collaboratively ... policies to determine if submitted requests require a prior authorization review or redirect as required. + Entering data...for a bonus component that would be dependent on pre -defined performance factors. As part of our total compensation… more
    Evolent Health (11/12/24)
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  • RN Care Manager - Rex Case Management Services

    UNC Health Care (Raleigh, NC)
    …communicate to patient/family/care team on an ongoing basis. Identify required authorization for post-discharge services and refer to the appropriate post-discharge ... and departmental policies and guidelines as needed. May assist with training/ pre -cepting as needed as assigned. **Other Information** Other information: **Education… more
    UNC Health Care (10/26/24)
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  • RN Care Manager (Per Diem) - NC Surgical Hospital

    UNC Health Care (Chapel Hill, NC)
    …communicate to patient/family/care team on an ongoing basis. Identify required authorization for post-discharge services and refer to the appropriate post-discharge ... and departmental policies and guidelines as needed. May assist with training/ pre -cepting as needed as assigned. **Other Information** Other information: **Education… more
    UNC Health Care (08/28/24)
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