- UNC Health Care (Smithfield, NC)
- …through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- Fresenius Medical Center (Knightdale, NC)
- **About this role:** As a Clinical Manager with Fresenius Medical Care , you will ensure that quality patient care is delivered while maintaining clinical ... of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing...leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area… more
- Veterans Affairs, Veterans Health Administration (Garner, NC)
- …licensed practical nurses, pharmacists, social workers and medical support assistants. The Registered Nurse will serve as a primary care nurse in support ... System is looking to fill several full time Registered Nurse vacancies for the Garner VA...health and health education needs. Previous experience in the care manager role and coordinating care… more
- CVS Health (Raleigh, NC)
- …holidays; however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- UNC Health Care (Morrisville, NC)
- …is to improve the health and well-being of the unique communities we serve. Summary: The Care Manager RN plays a crucial role in providing comprehensive and ... healthcare more affordable. We are in search of a Care Manager to join our team! This...within 7 years of employment date. **Licensure/Certification Requirements:** * Registered Nurse with a valid license to… more
- LifePoint Health (Wilson, NC)
- …resources for optimal discharge planning Drag Edit Delete *Required Licenses* Registered Nurse - Current/active North Carolina or compact RN license - BLS ... internal and external delivery of healthcare services. The Case Manager integrates the roles of Utilization Management,... Management, Case Management and Discharge Planning. The Case Manager is responsible for care coordination and… more
- CenterWell (Raleigh, NC)
- …years clinical RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional ... caring community and help us put health first** Conviva Care Solutions is seeking a RN who...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- UNC Health Care (Rocky Mount, NC)
- …recommends eligibility for pathways, protocols, or guidelines that could improve patient care and utilization of resources. 2. Performs concurrent and ... reviews for private insurance companies, Medicare and Medicaid, in accordance with utilization review guidelines. Tactfully and effectively informs Manager of… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …VA Health Care System is looking to fill one (1) full time Registered Nurse Manager vacancy for the Emergency Department service line. Responsibilities ... staff, and Medical Support Assistants. The work of the Nurse Manager is supported by an excellent...in a Health-Related Field Masters in Nursing Preferred Certification(s) Nurse Executive CEN Critical Care RN… more
- Deloitte (Raleigh, NC)
- …as clinical registered nurse , physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics RN , ... payments are appropriate for the type and level of care provided. + Strategic Risk: Helping clients to embrace...nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required… more
- UNC Health Care (Raleigh, NC)
- **Description** UNC Home Care is seeking a candidate with process improvement experience. Will consider candidates with RN or Physical Therapy experience. This ... reports summarizing quality improvement findings. 5. Collaborates with the Operations Manager to select patients for audit review. Reviews patient records to… more
- Elevance Health (Durham, NC)
- …states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of ... **Telephonic Nurse Case Manager II** **Location:** This...claims or service issues. + Assists with development of utilization / care management policies and procedures. **Minimum Requirements:**… more
- CVS Health (Raleigh, NC)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... role in maintaining quality standards and regulatory compliance across managed care operations. **Key Responsibilities:** + Lead and support monthly NCQA… more
- Highmark Health (Raleigh, NC)
- …established industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create ... **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides… more
- Granville Medical Center (Oxford, NC)
- …Summary: Performs all clerical and secretarial duties related to unit under supervision of Nurse Manager or Charge Nurse . Coordinates activities at nursing ... responsibility and accountability for a group of patients, providing care through the continues utilization of the...clean environment under the direction and supervision of the Registered Nurse in charge of the unit.… more
- Organon & Co. (Raleigh, NC)
- …Education, Experience and Skills** + BA/BS. + Two plus years of managed care account manager or equivalent experience. + Customer knowledge and/or ... as well as other extended account team members to maximize appropriate utilization of Organon products. Integrates Senior Leadership into the overall business… more