- 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 (Clayton, 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
- CenterWell (Raleigh, NC)
- **Become a part of our caring community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care ... of three years clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional… 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
- 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
- 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
- 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
- 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
- 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