• Registered Nurse Manager…

    Veterans Affairs, Veterans Health Administration (Durham, NC)
    …The Durham VA Health Care System is looking to fill one (1) full time Registered Nurse - Nurse Manager vacancy. Responsibilities Job Description/ Scope of ... Practice: The Registered Nurse Manager for Cardiovascular Labs (CV...Catherization Laboratory, Interventional Recovery Unit, and Radiology Services. The RN Manager will assume responsibility for daily operations and… more
    Veterans Affairs, Veterans Health Administration (01/12/25)
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  • Registered Nurse (Sterile…

    Veterans Affairs, Veterans Health Administration (Durham, NC)
    Summary The Durham VA Health Care System is looking to fill one (1) Registered Nurse vacancy for the Sterile Processing Services (SPS) Department. The SPS ... Quality Registered Nurse promotes a culture of quality...safety of patients, visitors, and staff. Manages core Quality Management programs to include Survey Readiness, External Peer Review… more
    Veterans Affairs, Veterans Health Administration (01/16/25)
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  • Supervisor, Utilization Management

    Centene Corporation (Raleigh, NC)
    …Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
    Centene Corporation (01/16/25)
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  • Care Manager RN - Weekends ( Remote

    Highmark Health (Raleigh, NC)
    …Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
    Highmark Health (01/07/25)
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  • Prior Authorization Specialist RN PRN

    Intermountain Health (Raleigh, NC)
    …REGISTRATION, LICENSE (*indicates primary source verification requirement) Required: + Active Registered Nurse License Preferred: + Certified Healthcare Access ... Associate (CHAA) EXPERIENCE Required: + Licensed Registered Nurse + Minimum of 2 years'...experience in acute clinical nursing setting + Knowledge of utilization management and case management more
    Intermountain Health (01/18/25)
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  • RN Clinical Consultant, Claims Shared…

    Guardian Life (Raleigh, NC)
    …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
    Guardian Life (12/20/24)
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  • Care Manager II, Complex, RN /LCSW

    AmeriHealth Caritas (Wilson, NC)
    …complete, and accurate documentation of Member interactions in ACFC electronic care management platforms where applicable. + Monitor appropriate utilization and ... it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other… more
    AmeriHealth Caritas (01/10/25)
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  • Health Coach Consultant RN Chronic…

    CVS Health (Raleigh, NC)
    …health care more personal, convenient and affordable. **Position Summary** **The Health Coach Consultant RN role is 100% remote work from home and candidates can ... US** The position is full time, 40 hours/week, and remote for a RN with a compact...every 4-6 weeks)** The Health Coach Consultant: Chronic Condition Nurse utilizes a collaborative process of assessment, planning, implementation,… more
    CVS Health (01/10/25)
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  • Transition of Care Associate ( Remote )

    CVS Health (Raleigh, NC)
    …visit, inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN , the TOC Coach ensures the member experiences a ... impact on our members, who are enrolled in Care Management and present with a wide range of complex...or changes in condition to be transitioned back to RN . + Complete post discharge call and required assessments… more
    CVS Health (01/22/25)
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  • Senior Clinical Research Associate - Organ…

    United Therapeutics (Raleigh, NC)
    …Degree preferably in a health, biological sciences, or related field or + Registered Nurse ( RN ) nursing qualifications or relevant clinical research ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
    United Therapeutics (11/28/24)
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  • Senior Process Improvement Professional

    Humana (Raleigh, NC)
    …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... project management and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance and appeals +… more
    Humana (01/23/25)
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