- 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)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… 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 (Knightdale, 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)
- …VA Health Care System is looking to fill one (1) full-time Chief Registered Nurse vacancy for Surgery. Responsibilities Job Description/Scope of Practice The ... defined in the four (4) dimensions outlined in the Nurse Qualification Standards. PRACTICE (Ethics, Resource Utilization )...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …VA Health Care System is looking to fill one (1) full time Registered Nurse vacancy for the Referral Coordinator Team. Responsibilities Job Description/Scope ... referral appointments. This change shifts the work of multiple clinical staff members to Referral Coordination Teams (RCT) of...level degree in Nursing may have opportunity to become registered as a nurse with a state… 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)
- …+ 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 (Raleigh, NC)
- …Service/Health Services (as applicable to hiring program) or Associates degree with a Registered Nurse with Behavioral Health experience/ background with 3 years ... we do it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization… more
- Evolent (Raleigh, NC)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are… more
- 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
- UNC Health Care (Raleigh, NC)
- …in Nursing; Licensure/Certification Requirements: * Must be licensed to practice as a registered nurse in the state of North Carolina Professional Experience ... the integrating and functions of point of entry case management, utilization review, and effective patient flow activities. Responsibilities: 1. Incoming Transfer… 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 (Raleigh, NC)
- …Nursing **Licensure/Certification Requirements:** * Must be licensed to practice as a registered nurse in the state of North Carolina **Professional Experience ... appropriate patient flow and bed planning with a focus on increasing bed utilization and reducing patient/bed turnaround delays with a decrease in length of stay… more