- Humana (Raleigh, NC)
- …health first** Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge ... and Utilization Management experience. The Utilization Management Behavioral Health Nurse ...Qualifications** + Minimum of Associate's Degree in Nursing + Registered nurse with active Compact Licensure and… more
- CVS Health (Raleigh, NC)
- …Position Summary This is a full-time, 40 hour/week, remote role for a RN with a compact license and experience in adult Medical-Surgical Nursing and Chronic ... -Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits… more
- Elevance Health (Cary, NC)
- …within the scope of licensure including, for example, assisting the responsible RN with telephonic assessments for the identification, evaluation, coordination ... of consideration for employment. **Managed Care Coordinator Clinician Non RN ** + Job Family: MED > Licensed/Certified - Other...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- Marriott (Raleigh, NC)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... with supervisor keeping him/her informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational health nurse … more
- Sharecare, Inc. (Raleigh, NC)
- …for supporting goals and objectives of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, ... the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager....will follow company policy to transfer call to an RN or appropriate colleague when member needs are outside… more
- Centene Corporation (Raleigh, NC)
- …flexibility. **Position Purpose:** Supervise and facilitate the daily operations of the case management and utilization management functions + Oversee the ... workflow and day-to-day operations of high risk case management and utilization management functions, including implementation of policies and procedures +… more
- Elevance Health (Cary, NC)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... Preferred Skills, Capabilities, and Experiences: + Bilingual in Spanish. + Previous utilization management experience highly desirable. + Experience with taking… more