- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, ... changing environment- flexibility in assignment. * Proficient in Utilization Review process including benefit interpretation, contract language, medical and… more
- Granville Medical Center (Oxford, NC)
- Registered Nurse - ICU Location: Granville Health System, Oxford, NC About Granville Health System: For over a century, Granville Health System has been at the ... Health System has extended its services throughout Granville County, ensuring convenient medical care access for its residents. The Granville Health System main… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review / Medical and Case Management services for Workers' Compensation. The Workers' ... Compensation Nurse Case Reviewer collaborates with medical care...for timely return to work. + Provides case management, utilization review , continued stay reviews, and based… more
- Granville Health System (Oxford, NC)
- Registered Nurse # ICU Location: Granville Health System, Oxford, NC # About Granville Health System: For over a century, Granville Health System has been at the ... Health System has extended its services throughout Granville County, ensuring convenient medical care access for its residents. The Granville Health System main… more
- Elevance Health (Durham, NC)
- ** Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... 48 hours of receipt and meet the criteria._** The ** Nurse Case Manager II** is responsible for care management...management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …and performance monitoring, oversees all Workers' Compensation (WC) Case Management and Utilization Review (UR) Programs. + Collaborates with the Chief ... for the Casualty and Clinical Services departments which in turn includes Utilization Management, Case Management and Population Health divisions. The position can… more
- UNC Health Care (Chapel Hill, NC)
- …cost-effective discharge planning. + Serve as a key resource in case management, utilization review , and discharge planning. + Stay compliant with all regulatory ... assess the risk level of patients based on various factors such as medical conditions, social determinants of health, and behavioral health needs. b. Develop… more
- UNC Health Care (Chapel Hill, NC)
- …through the integrating and functions of point of entry case management, utilization review , and effective patient flow activities. Responsibilities: 1. Capacity ... tasks as appropriate. 4. Clinical Appropriateness Assessment- Using established medical necessity criteria products and departmental guidelines perform assessments… more