- UNC Health Care (Chapel Hill, NC)
- …whose mission is to improve the health and well-being of the unique communities we serve. RN Utilization Manager position specifically for a Utilization ... 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
- UNC Health Care (Hendersonville, NC)
- …to improve the health and well-being of the unique communities we serve. Summary: The Care Manager - RN provides ongoing support and expertise through ... management, utilization review and discharge planning. The Care Manager must be highly organized professional...Required * Must be licensed to practice as a Registered Nurse in the state of North… more
- Fresenius Medical Center (Charlotte, 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
- Fresenius Medical Center (Greensboro, NC)
- …maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line. ... regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal,… more
- Fresenius Medical Center (Lenoir, NC)
- … care pre, during and post procedure, under the direction of the Facility Manager and/or Charge Registered Nurse , utilizing standard nursing techniques to ... quality standards. + Accountable for outstanding quality of patient care , as defined by the FVC quality goals, to...the facility and reports any issues to the Facility Manager . + Ensures a clean, safe and sanitary environment… more
- UNC Health Care (Hendersonville, NC)
- …daily with the Care Manager to manage level of care transitions & appropriate utilization of services. Coordinates with the appropriate staff/payers ... well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued...Required * Must be licensed to practice as a Registered Nurse in the state of North… more
- UNC Health Care (Hillsborough, NC)
- …mission is to improve the health and well-being of the unique communities we serve. This RN Care Manager will be supporting the UNC Ortho Clinic, Women's, ... management, utilization review and discharge planning. The Care Manager must be highly organized professional...**Professional Experience Requirements:** * Two (2) years of health care experience as a Registered Nurse… more
- CenterWell (Asheville, NC)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... is not a remote or work-from-home position.** The **Clinical Manager ** coordinates and oversees all direct care ...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Outpatient, DME, and Complex Care Needs. Essential Qualifications + Current licensed Registered Nurse ( RN ) with state licensure. Must retain active and ... Utilization Management services to its clients. The Utilization Review Appeals Nurse performs daily appeal...care setting. + 3+ years' experience in clinical nurse setting preferred. + Grievance experience preferred. + TPA… more
- LifePoint Health (Wilson, NC)
- …and external resources for optimal discharge planning *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
- Sharecare, Inc. (Raleigh, NC)
- …telephonic support in an appropriate, efficient and cost-effective manner while ensuring high quality care . The RN coordinates with the Primary Care Provider ... total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is...according to the disease management program intervention guidelines. An RN is supervised by an Operations Manager … more
- Fresenius Medical Center (New Bern, NC)
- **PURPOSE AND SCOPE:** Ensure the provision of quality patient care to all hospitalized patients in the most efficient manner in accordance with company policy. ... contracted facilities. Ensure efficient staff/ patient scheduling and efficient staffing utilization following company policy while maintaining a safe environment. +… more
- UNC Health Care (Morrisville, 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
- LifePoint Health (Henderson, NC)
- …* Other responsibilities, as directed. **Job:** **Nursing* **Organization:** ** **Title:** * RN Case Manager Full Time* **Location:** *NC-Henderson* **Requisition ... beds, Maria Parham Health is equipped for every health care need one can encounter. We are fully licensed...Social Worker for daily issues regarding quality, resource management, utilization review, and discharge planning. * Reviews the delivery… more
- UNC Health Care (Hendersonville, NC)
- …PARDEE Other information: Qualifications Required * Must be licensed to practice as a Registered Nurse in the state of North Carolina or one of compact ... well-being of the unique communities we serve. Summary: The Clinical Nursing Manager leads operations of an assigned clinical area. Responsible for daily direction,… more
- Elevance Health (Winston Salem, NC)
- …weekends and holidays, and starting at 5 pm or 10 pm EST.** The BH Care Manager I responsible for managing psychiatric and substance abuse or substance abuse ... depression, and insightful analytics to improve the delivery of care . **This is an individual contributor role and the...equivalent background. + Current active unrestricted license, such as RN LCSW LMHC LPC (as allowed by applicable state… more
- UNC Health Care (Rocky Mount, NC)
- …Nursing preferred. **Licensure/Certification Requirements:** * RN Licensed to work as a Registered Nurse in the state of North Carolina. + Certification in ... the unique communities we serve. **Summary:** The Recovery Audit Nurse will work closely with other Business Office staff...claims denied by insurance companies with primary focus on managed- care and commercial payers (will work closely with Case… more
- UNC Health Care (Apex, NC)
- **Description** **_UNC Rex Rehabilitation and Nursing Care Center of Apex is a skilled nursing facility with 107 beds. We care for long-term care residents ... Acts as liaison between staff, physicians, and management. Also performs direct patient care . Responsibilities: 1. Ensures care delivered to each patient is… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The Behavioral Health Case Manager FEP, depending on their clinical expertise, will be responsible for organizing appropriate care , ... use and monitoring of healthcare resources to ensure high-quality care for our members. When necessary, they will collaborate...members identified as high risk, high cost, or high utilization cases. + May review alternative treatment plans for… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** Dependent on clinical discipline, the Case Manager / Health Coach coordinates appropriate care , resources and/or services of selected member ... populations. Provides guidance and promotes effective utilization and monitoring of health care resources...internally and externally. **What You'll Bring (Hiring Requirements)** * RN with 3 years of clinical and/or case management… more