- 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
- UNC Health Care (Raleigh, NC)
- …_We are currently seeking an experienced nurse to join our dynamic team as an RN Utilization Manager . Role is full time, 40 hours per week, on site._ ... for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care ...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… 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 ... 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 (Durham, NC)
- Summary The Durham VA Health Care System is looking to fill one (1) full time Registered Nurse ( Care Manager ) vacancy for the Patient Aligned Care ... irrigations and education related to disease/self-management and equipment The Registered Nurse in this position will serve...health and health education needs. Previous experience in the care manager role and coordinating care… 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 Durham Specialties Clinic. Demonstrates ... cancer, congestive heart failure and other chronic diseases. The Registered Nurse within these clinics which includes...health and health education needs. Previous experience in the care manager role and coordinating care… more
- UNC Health Care (Chapel Hill, NC)
- …and satisfaction by promoting high-quality, coordinated care . **What You'll Do** As a Care Manager RN , you'll: + Provide ongoing support and clinical ... well-being of the unique communities we serve. Summary: The Care Manager RN plays a...within 7 years of employment date. **Licensure/Certification Requirements:** * Registered Nurse with a valid license to… more
- UNC Health Care (Chapel Hill, 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 ... + Would like to learn how to be a Care Manager or would like to continue...within 7 years of employment date. **Licensure/Certification Requirements:** * Registered Nurse with a valid license to… more
- UNC Health Care (Raleigh, NC)
- …and functions of case management, utilization review and discharge planning. The Care Manager must be highly organized professional with great attention to ... Care Management Assistant. Consult Social Worker and/or Utilization Manager per established departmental protocol. Maintain...**Professional Experience Requirements:** * Two (2) years of health care experience as a Registered Nurse… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Other duties as assigned. Essential Qualifications + Active and unrestricted license as a Registered Nurse ( RN ) + Bachelor's degree in nursing, (or ... About The Role The Manager , Utilization Management (UM) will manage...will have a strong clinical background within a managed care setting including a high-level understanding of prior authorization… 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
- CenterWell (Lillington, NC)
- …A minimum of 2 years of experience as a Registered Nurse ( RN ). + Previous experience in home-based care required, including home health, hospice, and/or ... Lillington, NC branch location.** The ** RN Clinical Manager ** coordinates and oversees all direct care ...Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or… 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
- Gentiva (Cary, NC)
- …team. This role is ideal for a licensed Registered Nurse ( RN ) with strong leadership experience in hospice care , home health, or clinical operations ... Join a team that values compassion, leadership, and meaningful work-when life matters most. RN Branch Director, RN Branch Manager , Hospice Branch Director,… more
- Humana (Raleigh, NC)
- …concerns.** **Use your skills to make an impact** **Required Qualifications** + **Active Registered Nurse ( RN ) Multi-state/Compact State license with no ... Nurse provides medical guidance, assists with access to care concerns, screens for program referrals, provides information on...is a remote position, with oversight from the NAL Manager ; and they are expected to work independently with… 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 ... Case Management services for Workers' Compensation. The Workers' Compensation Nurse Case Reviewer collaborates with medical care ...and the evaluation of coverage under the Plan. The Nurse Case Manager reports to the Casualty… 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
- 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
- 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
- Sharecare (Raleigh, NC)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... support in an appropriate, efficient and cost-effective manner while ensuring high quality care . The Disease Management Nurse works with participating members to… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role BHPS provides Utilization Management (UM) services to its clients, ensuring high-quality, clinically sound decision-making. The Clinical Appeal and ... Grievance Nurse is responsible for conducting daily clinical and benefit...environment. The position reports directly to the Clinical Appeal Manager . Note: This job description is not intended to… more