- Cognizant (Raleigh, NC)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- UNC Health Care (Kinston, NC)
- …Minimum 3-5 years of applied clinical experience as a Registered Nurse required. + 2 years utilization review, care management, or compliance experience ... denials management preferred. + **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a Registered Nurse in the state of North Carolina. **Job… more
- CVS Health (Raleigh, NC)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules...will include weekends, holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to… more
- UNC Health Care (Kinston, NC)
- …EXPERIENCE REQUIREMENT Five (5) years of health care experience as a Registered Nurse . LICENSURE/REGISTRATION/CERTIFICATION Licensed to practice as a ... the unique communities we serve. Summary: This position facilitates utilization management processes to support the right care is...Registered Nurse in the state of North Carolina. KNOWLEDGE, SKILLS… more
- Fresenius Medical Center (Fayetteville, NC)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Fresenius Medical Center (Garner, NC)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Veterans Affairs, Veterans Health Administration (Salisbury, NC)
- Summary The Registered Nurse (Dialysis) functions as primary nurse for End-Stage Renal Disease (ESRD) patient panel and serves as key resource assisting ... patients to navigate the healthcare system. Responsibilities The Registered Nurse (Dialysis) demonstrates knowledge, skill and leadership when providing,… more
- UNC Health Care (Smithfield, NC)
- …of employment date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North Carolina. **Professional ... care episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse (RN)** in the (appropriate state)… more
- Evolent (Raleigh, NC)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- Grace Hospital (Morganton, NC)
- …and contributions to improving healthcare delivery. Must have licenses to practice as a Registered Nurse in North Carolina and have practiced 3 years in an ... Blue Ridge HealthCare Hospitals - Morganton Clinical Case Management THE ORGANIZATION At UNC Health...THE POSITION Join our dynamic healthcare team as a Utilization Management RN Weekender, where you will play a… more
- UNC Health Care (Chapel Hill, NC)
- … Nurse Practitioner, Physician Assistant, Clinical Pharmacist Practitioner, Certified Nurse Midwife, Certified Registered Nurse Anesthetist) in the ... **Description** Have you considered a Neonatal Nurse Practitioner career with UNC Health? This opportunity...At all times care will be provided through independent utilization of approved protocols and procedures and under the… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …assurance standards and MagnaCare policies and procedures. Essential Qualifications + Currently licensed Registered Nurse in the state of NY, or the ability to ... management, utilization review, continued stay reviews, and based on clinical judgment and state WCB Medical Treatment Guidelines. + Knowledgeable and compliant… more
- KBR (Fayetteville, NC)
- …to obtain a clearance. + Current RN license; full, active, and unrestricted license as a Registered Nurse in one of any US State, the District of Columbia, Guam, ... Title: Special Operations Nurse Case Manager (USASOC DPA, Fort Bragg, NC)...of professional health nursing principles, practices, and procedures in clinical settings in order to analyze the full scope… more
- UNC Health Care (Chapel Hill, NC)
- …of professional nursing. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North Carolina. **Professional ... of the unique communities we serve. Summary: The Transplant Nurse Coordinator (TNC) is responsible for coordinating the total...for both patient and graft survival. Reviews patient resource utilization with administrative and clinical staff to… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Nursing, Maternity Nursing, Population health, Disease Management. + Current licensed Registered Nurse (RN) with compact state licensure; bachelor's degree ... services to its clients. Cases are maintained by the Nurse Case manager. The Nurse Case Manager...HIPAA) for Case Management and self-insured clients. + Uses clinical tools for patient assessment, creating individualized care plans.… more
- CenterWell (Shelby, NC)
- …Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse (RN) license or Compact State RN license with ... on-site at our Shelby, NC branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...A minimum of 2 years of experience as a Registered Nurse (RN). + Home health experience… more
- CenterWell (Asheville, NC)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... position comes with a $10K sign-on bonus.** + The ** Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse in a home care, with… more
- CenterWell (Raleigh, NC)
- …Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse (RN) license or Compact State RN license with ... hours spanning Friday afternoon through Monday afternoon to support clinical operations across multiple branch locations.** The **Weekend Regional...A minimum of 2 years of experience as a Registered Nurse (RN). + Home health experience… more
- Novant Health (Wilmington, NC)
- …for career advancement. Our supportive culture ensures a fulfilling work experience. A Clinical Coordinator is a Registered Nurse who functions as ... work shift activities in the clinical area. Assists the Nurse Manager with continuous quality improvement, personnel utilization , performance appraisals,… more