- 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
- Evolent (Raleigh, NC)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management staff,… more
- 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
- 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