• Clinical Registered Nurse

    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
    Cognizant (10/07/25)
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  • Utilization Management Nurse

    Brighton Health Plan Solutions, LLC (NC)
    …member's benefit coverage while working remotely. Primary Responsibilities * Performs clinical utilization reviews using evidenced based guidelines, policies and ... requirements. * Duties as assigned. Essential Qualifications * Current Registered Nurse (RN) with state licensure. Must...within managed care setting. * 3+ years' experience in clinical nurse setting preferred. * TPA Experience… more
    Brighton Health Plan Solutions, LLC (10/11/25)
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  • Utilization Management Nurse

    CVS Health (NC)
    …both verbal and written **Required Qualifications** - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in ... we do it all with heart, each and every day. Requisition Job Description Utilization Management is a 24/7 operation and work schedule may include weekends and… more
    CVS Health (10/10/25)
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  • Utilization Review Nurse

    UNC Health Care (Kinston, NC)
    …EXPERIENCE REQUIREMENT** + Five (5) years of health care experience as a Registered Nurse . **LICENSURE/REGISTRATION/CERTIFICATION** + Licensed to practice as a ... the unique communities we serve. **Summary:** This position facilitates utilization management processes to support the right care is...Registered Nurse in the state of North Carolina. **KNOWLEDGE, SKILLS… more
    UNC Health Care (09/04/25)
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  • Dialysis Clinical Manager Registered

    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 (10/01/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Greensboro, 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
    Fresenius Medical Center (10/11/25)
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  • Registered Nurse - Case Manager

    ERP International (Cherry Point, NC)
    **Overview** ERP International is seeking full-time ** Registered Nurse (RN) Case Manager** in support of theNaval Health Clinic Cherry Point, NC. Apply online ... Management Specialist (CDMS) o Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN) o American Board for Occupational Health… more
    ERP International (10/06/25)
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  • Case Management Registered Nurse

    HCA Healthcare (Asheville, NC)
    …you passionate about delivering patient-centered care?** Submit your application for Care Manager Registered Nurse position and spend more time at the bedside ... shape business and operational outcomes, or work to deliver clinical excellence behind the scenes in data science, case...weeks. This position is onsite at Mission Hospital. The Registered Nurse (RN) CM is responsible for… more
    HCA Healthcare (09/25/25)
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  • Case Manager, Registered Nurse

    CVS Health (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
    CVS Health (10/02/25)
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  • Registered Nurse RN Case Manager…

    AdventHealth (Fletcher, NC)
    …and experiences you'll need to succeed:** **Minimum qualifications:** + 1 years relevant clinical RN experience + Registered Nurse - State Licensure ... ** Registered Nurse Case Manager -** **AdventHealth...to support productivity, efficiency and maintain best practice visit utilization . + Assesses physical, functional, psychosocial, social, spiritual, educational,… more
    AdventHealth (09/19/25)
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  • Registered Nurse (Community Living…

    Veterans Affairs, Veterans Health Administration (Salisbury, NC)
    …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... guidance in how to improve care provided to residents and families. The nurse will assist in directing the provision of nursing education, orientation, competencies… more
    Veterans Affairs, Veterans Health Administration (10/10/25)
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  • Manager, Utilization Management

    Brighton Health Plan Solutions, LLC (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
    Brighton Health Plan Solutions, LLC (10/11/25)
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  • SNF Utilization Management RN - Compact Rqd

    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
    Humana (09/12/25)
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  • Registered Nurse Home Care PACE…

    HCA Healthcare (Asheville, NC)
    …Council approval. **Required License** : . Must have and maintain current licensure as registered nurse with the North Carolina Board of Nursing. Compact license ... integrity. We care like family! Jump-start your career as a Home Care Clinical Coordinator today with CarePartners. This position is eligible for a sign-on bonus,… more
    HCA Healthcare (07/14/25)
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  • Utilization Review Clinician - Behavioral…

    Centene Corporation (Raleigh, NC)
    …required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required Pay Range: ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
    Centene Corporation (10/04/25)
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  • Registered Nurse , RN - Patient Flow…

    Novant Health (Charlotte, NC)
    …or critical care required, patient flow experience a plus) + Strong clinical judgment & multitasking skills + Tech-savvy and confident communicating with physicians ... + Experience: + Two year, required. + Previous leadership and bed utilization experience is preferred. + Licensure/Certification: Current RN license, required. +… more
    Novant Health (09/16/25)
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  • Neonatal Nurse Practitioner (NNP) - Peds…

    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
    UNC Health Care (07/30/25)
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  • Disease Management Nurse - Remote

    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
    Sharecare (09/13/25)
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  • Consultant, Nurse Disability I

    Lincoln Financial (Raleigh, NC)
    …**What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible… more
    Lincoln Financial (10/10/25)
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  • Transplant Nurse Coordinator (Per Diem)…

    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
    UNC Health Care (09/24/25)
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