- 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
- CVS Health (Raleigh, NC)
- …/benefit management function. **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure ... all with heart, each and every day. **Position Summary** Medicare Precertification Utilization Management Nurse Consultant position: _Utilization Management is a… 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
- UNC Health Care (Raleigh, 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
- CVS Health (Raleigh, NC)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… 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
- 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
- Granville Health System (Oxford, NC)
- …6 months of hire date. # # Position Overview - RN: A professional Registered Nurse (RN), caregiver who assumes responsibility and accountability for multiple ... a group of patients, providing care through the continued utilization of the nursing process in collaboration with other...an accredited school of nursing with current North Carolina registered nurse license is required. A minimum… 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 (Youngsville, NC)
- …Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse (RN) license or Compact State RN license with ... sit on-site at our Youngsville, NC branch location.** The ** 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 (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
- Deloitte (Raleigh, NC)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… 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 ... (CQI)Participates in CQI efforts to optimize patient and graft outcomes. Reviews clinical practices and patient resource utilization to identify areas for… more
- UNC Health Care (Chapel Hill, NC)
- …Managers, Social Workers, and Care Management Assistants. + Candidate must be a ** Registered Nurse (RN)** or **Licensed Clinical Social Worker (LCSW/LCSWA)** ... Care Management Department team(s). Provides management direction to Case Managers, Utilization Managers, Clinical Social Workers, Clinical Authorization… more
- Granville Health System (Oxford, NC)
- Registered Nurse # Emergency Department Location: Granville Health System, Oxford, NC # About Granville Health System: For over a century, Granville Health ... with both professional and personal fulfillment. Position Overview: A professional Registered Nurse (RN), caregiver who assumes responsibility and accountability… more
- UNC Health Care (Chapel Hill, NC)
- …degree in Nursing **Licensure/Certification Requirements:** * Must be licensed to practice registered nurse in the state of North Carolina **Professional ... the integrating and functions of point of entry case management, utilization review, and effective patient flow activities. Responsibilities: 1. Capacity Planning-… more
- UNC Health Care (Garner, NC)
- …major in nursing within 7 years of employment date. **Licensure/Certification Requirements:** * Registered Nurse with a valid license to practice in North ... Experience Requirements:** * Minimum of 2 years of experience as a registered nurse . **Knowledge/Skills/and Abilities Requirements:** * Strong knowledge of risk… more