- 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
- 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
- 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 (Carrboro, 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
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- Summary The Durham VA Health System, has 1 vacancy for a part-time Registered Nurse , working in the Surgical Intensive Care Unit (SICU). Responsibilities Job ... 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… more
- CVS Health (Raleigh, 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
- Brighton Health Plan Solutions, LLC (Chapel Hill, 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
- 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
- CVS Health (Raleigh, NC)
- …and obtain additional licenses required per account needs - 3+ years as a Registered Nurse performing chronic condition assessments and education in a clinic, ... optimal health status. - Assessment of Members through the use of clinical tools and information/data review, conducts comprehensive evaluation of member's needs and… more
- 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
- 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
- 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
- CenterWell (Lillington, NC)
- …Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse (RN) license or Compact State RN license with ... on-site at our Lillington, NC branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...A minimum of 2 years of experience as a Registered Nurse (RN). + Home health experience… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …in all WC State Reporting and audits. Essential Qualifications + Currently licensed Registered Nurse (RN), Nurse Practitioner (NP), or Physician Assistant ... more effective and affordable and will be responsible for the Casualty and Clinical Services departments which in turn includes Utilization Management, Case… more
- UNC Health Care (Chapel Hill, NC)
- …major in nursing within 7 years of employment date. **Licensure/Certification Requirements:** * Registered Nurse with a valid license to practice in North ... + Serve as a key resource in case management, utilization review, and discharge planning + Stay compliant with...* Minimum of 2 years of experience as a registered nurse . **Knowledge/Skills/and Abilities Requirements:** * *… more
- UNC Health Care (Chapel Hill, NC)
- …degree in Nursing **Licensure/Certification Requirements:** * Must be licensed to practice registered nurse in the state of North Carolina **Professional ... the integrating and functions of point of entry case management, utilization review, and effective patient flow activities. Responsibilities: 1. Capacity Planning-… more
- Gentiva (Cary, NC)
- …Director to join our leadership team. This role is ideal for a licensed Registered Nurse (RN) with strong leadership experience in hospice care, home health, ... or clinical operations management. If you're a natural leader who...growth through census development, referral management, and efficient resource utilization + Maintain strong relationships with physicians, referral sources,… more
- UNC Health Care (Garner, NC)
- …major in nursing within 7 years of employment date. **Licensure/Certification Requirements:** * Registered Nurse with a valid license to practice in North ... Experience Requirements:** * Minimum of 2 years of experience as a registered nurse . **Knowledge/Skills/and Abilities Requirements:** * Strong knowledge of risk… more
- 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 ... maximizing the outcomes for both patient and graft survival. Reviews patient resource utilization with administrative and clinical staff to identify areas for… more