- 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
- 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
- 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
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …Durham VA Health Care System is looking to fill one (1) full time Registered Nurse Manager vacancy for the Emergency Department service line. Responsibilities ... an excellent administrative staff, including a Quality Consultant, a Clinical Nurse Educator, and an Administrative Officer...level degree in Nursing may have opportunity to become registered as a nurse with a state… 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
- Granville Medical Center (Oxford, NC)
- Registered Nurse - Emergency Department Location: Granville Health System, Oxford, NC About Granville Health System: For over a century, Granville Health System ... with both professional and personal fulfillment. Position Overview: A professional Registered Nurse (RN), caregiver who assumes responsibility and accountability… more
- Datavant (Raleigh, NC)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- UNC Health Care (Morrisville, NC)
- …major in nursing within 7 years of employment date. **Licensure/Certification Requirements:** * Registered Nurse with a valid license to practice in North ... self-management. 3. Risk Segmentation: a. Utilize standardized tools and clinical judgment to identify and assess the risk level...* Minimum of 2 years of experience as a registered nurse . **Knowledge/Skills/and Abilities Requirements:** * *… more
- Highmark Health (Raleigh, NC)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more