- LifePoint Health (Louisburg, NC)
- …**Please select a valid job field* **Organization:** **Maria Parham Franklin* **Title:** * Registered Nurse Utilization Review Coordinator* **Location:** ... Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …for complex case discussions for all staff. Essential Qualifications * Current licensed Registered Nurse (RN) with state licensure. Must retain active licensure ... a high pace and changing environment. * Proficient in Utilization Review process including benefit interpretation, contract...managed care setting. * 5+ years experience in clinical nurse setting preferred. * TPA Experience preferred. About At… more
- Centene Corporation (Raleigh, NC)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and...Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …and clinical committees. Essential Qualifications + Active and unrestricted license as a Registered Nurse (RN). + Bachelor's degree in nursing, (or equivalent ... About The Role The Director, Utilization Management (UM) will manage the Utilization...results and ensure existing and new regulatory initiatives. + Review multiple reports for statistical and financial tracking purposes… 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 ... a group of patients, providing care through the continued utilization of the nursing process in collaboration with other...accredited school of nursing with current licensure as a registered nurse in the state of North… 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 ... a group of patients, providing care through the continued utilization of the nursing process in collaboration with other...accredited school of nursing with current licensure as a registered nurse in the state of North… more
- Fresenius Medical Center (Raleigh, NC)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Fresenius Medical Center (Garner, NC)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Sharecare (Raleigh, NC)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- UNC Health Care (Raleigh, NC)
- …care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly ... policies. Responsibilities: 1. Identify Cases & Prioritize Day - Review work list to prioritize patients and identify new...date. **Licensure/Certification Requirements:** * Licensed to practice as a Registered Nurse in the state of North… more
- Highmark Health (Raleigh, NC)
- …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse (RN) license + Delaware RN license must be ... Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health… more
- UNC Health Care (Raleigh, NC)
- …through the integrating and functions of point of entry case management, utilization review , and effective patient flow activities. Responsibilities: 1. Incoming ... Licensure/Certification Requirements: * Must be licensed to practice as a registered nurse in the state of North Carolina Professional Experience Requirements: *… 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 ... Nursing **Licensure/Certification Requirements:** * Must be licensed to practice registered nurse in the state of North...* Must be licensed to practice registered nurse in the state of North Carolina **Professional Experience… more