• Dispute Resolution Reviewer I

    St. George Tanaq Corporation (Raleigh, NC)
    …Experience and Skills** + One (1) year of Medicare appeals, medical review , clinical, healthcare regulatory interpretation/application, healthcare compliance or ... university in healthcare or related discipline Additional experience in Medicare appeals, medical review , clinical, or other related experience in a healthcare… more
    St. George Tanaq Corporation (05/07/25)
    - Related Jobs

  • Dispute Resolution Reviewer III

    St. George Tanaq Corporation (Raleigh, NC)
    …+ Must have 2-3 years of medical dispute resolution or Medicare appeals, medical review , clinical, or related experience in a healthcare setting + Must have ... US Eastern, Central or Mountain Time Zones. **Responsibilities** + Reviews medical records/ case file, writes a reconsideration/dispute resolution decision that… more
    St. George Tanaq Corporation (06/25/25)
    - Related Jobs

  • RN Care Manager - Rex Case Management

    UNC Health Care (Raleigh, NC)
    …the unique communities we serve. **Our Case Management team is seeking a System-wide Complex Case Manager to provide support to a network of 6 owned and 10 ... teams + Provide warm handoffs to managed care partners or community navigators **4. Complex Case Rounds (Weekly)** + Facilitate systemwide case rounds for… more
    UNC Health Care (07/24/25)
    - Related Jobs

  • Case Manager, Registered Nurse - Oncology,…

    CVS Health (Raleigh, NC)
    …within time zone of residence.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (07/31/25)
    - Related Jobs

  • Case Manager RN

    Novant Health (Bolivia, NC)
    Job Summary RN/ Case Manager (Brunswick Medical Center - Bolivia, NC) The RN/ Case Manager serves as a leader of the complex discharge planning process and ... discharge plans. Collaborates with MSW for guidance with psychosocially complex cases. The RN Case Manager is...Friday for at least 2 weeks of orientation Department: Case Management RN Location: Brunswick Medical Center… more
    Novant Health (07/31/25)
    - Related Jobs

  • New York RN Case Manager

    Public Consulting Group (Raleigh, NC)
    …efficient, equitable, and client-centered + Handles case assignments, draft service plans, review case progress and determine case closure + Travels ... . PCG Health team helps our clients meet the complex financial, regulatory, and operational challenges of today's changing...options + Develops effective working relations and cooperate with medical team throughout the entire case management… more
    Public Consulting Group (07/18/25)
    - Related Jobs

  • Special Operations Nurse Case Manager…

    KBR (Fayetteville, NC)
    …employment. + Demonstrated knowledge of patient education principles and management of complex medical , psychosocial, and financial problems in order to enhance ... Title: Special Operations Nurse Case Manager / Case Manager (JSOC,...data relevant to primary health assessments including a detailed medical history in order to develop time sensitive treatment… more
    KBR (07/18/25)
    - Related Jobs

  • Case Manager Registered Nurse

    Novant Health (Charlotte, NC)
    …AM - 4:30 PM or 8:30 AM - 5:00 PM with rotating weekends + Department : Case Management + Location : Presbyterian Medical Center - Charlotte, NC The RN Case ... discharge plans. Collaborates with MSW for guidance with psychosocially complex cases. The RN Case Manager is...Best Places to Work in Healthcare by Becker's Hospital Review + Recognized as Leaders in LGBTQ+ Healthcare Equality… more
    Novant Health (07/20/25)
    - Related Jobs

  • Transplant Case Manager

    UNC Health Care (Chapel Hill, NC)
    …continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and management and discharge planning. The ... members of the multidisciplinary team. Proactively identifies patients/families with complex psychosocial/discharge planning needs. Assesses understanding of the risks… more
    UNC Health Care (07/25/25)
    - Related Jobs

  • Special Operations Nurse Case Manager…

    KBR (Fayetteville, NC)
    …employment. + Demonstrated knowledge of patient education principles and management of complex medical , psychosocial, and financial problems in order to enhance ... Title: Special Operations Nurse Case Manager (JFKSWC, Fort Bragg, NC) THIS POSITION...data relevant to primary health assessments including a detailed medical history in order to develop time sensitive treatment… more
    KBR (07/10/25)
    - Related Jobs