- Fresenius Medical Care (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 operations. ... or chronic kidney disease. Training and advancement: You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- 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)
- …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Raleigh, NC)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team.… more
- CVS Health (Raleigh, NC)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Fresenius Medical Center (Garner, 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 (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 ... 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 (Durham, NC)
- …VA Health Care System is looking to fill one (1) full-time Chief Registered Nurse vacancy for Surgery. Responsibilities Job Description/Scope of Practice The ... defined in the four (4) dimensions outlined in the Nurse Qualification Standards. PRACTICE (Ethics, Resource Utilization )...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- Summary The Durham VA Healthcare System is seeking (1) highly skilled/experienced Registered Nurse to serve within Medicine (Specialty Clinics). Demonstrates ... arthritis, cancer, congestive heart failure and other chronic diseases. The Registered Nurse within these clinics which includes Cardiology, Dermatology,… more
- CVS Health (Raleigh, NC)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …duties as assigned. Essential Qualifications + Active and unrestricted license as a Registered Nurse (RN) + Bachelor's degree in nursing, (or equivalent ... The Role The Manager, Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non- Clinical support staff. The… 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 Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… 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 ... work schedules will include weekends, holidays, and evening hours._ + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… 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
- Sharecare (Raleigh, NC)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… 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
- 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
- CenterWell (Lillington, 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 Lillington, 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
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …in all WC State Reporting and audits. Essential Qualifications + Currently licensed Registered Nurse (RN), Nurse Practitioner (NP), or Physician Assistant ... more effective and affordable and will be responsible for the Casualty and Clinical Services departments which in turn includes Utilization Management, Case… more
