- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… 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...accurate decisions + Ensure strict adherence to Appeals and Utilization Management (UM) processes and regulatory and… more