• RN Care Manager PRN

    AdventHealth (Hendersonville, NC)
    …to succeed:** + Associate's of Nursing Required + 2 Years Work Experience Required + Registered Nurse ( RN ) Required This facility is an equal opportunity ... events to enjoy in every season **The role youll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians… more
    AdventHealth (07/23/25)
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  • Care Manager RN (Delaware)

    Highmark Health (Raleigh, NC)
    …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN ... Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health… more
    Highmark Health (07/08/25)
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  • Clinical Case Manager

    LifePoint Health (Rutherfordton, NC)
    …execution, adaptation and outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, appropriateness of care and ... and mentors all staff in UR standards and LOS topics. Insures effective Utilization Review Process.1. Performs admission and concurrent medical record review… more
    LifePoint Health (06/09/25)
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  • Special Operations Nurse Case…

    KBR (Fayetteville, NC)
    Title: Special Operations Nurse Case Manager (JFKSWC, Fort Bragg, NC) THIS POSITION OFFERS RELOCATION. We attract the best minds in the world because our ... and services. We are seeking a stellar Special Operations Nurse Case Manager that will provide a...care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual… more
    KBR (07/10/25)
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  • Special Operations Nurse Case…

    KBR (Fayetteville, NC)
    Title: Special Operations Nurse Case Manager / Case Manager (JSOC, Fort Bragg, NC) THIS POSITION OFFERS RELOCATION. Belong. Connect. Grow. with KBR! KBR is a ... care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual...; full , active, and unrestricted license as a Registered Nurse or Licensed Clinical Social Worker… more
    KBR (07/18/25)
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  • Care Manager RN - (Remote)

    Highmark Health (Raleigh, NC)
    …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case … more
    Highmark Health (07/12/25)
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  • Manager, Behavioral Health Services - NC…

    Elevance Health (Winston Salem, NC)
    …The **Manager, Behavioral Health Services (CM** ) is responsible for the Behavioral Health Case Management team. **How you will make an impact:** + Serves as a ... cost of care initiatives. + May attend meetings to review CM process and discusses facility issues. + Hires,...of care for inpatient/outpatient BH services. + Ensures appropriate utilization of BH services through level of care determination,… more
    Elevance Health (07/24/25)
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  • Assistant Vice President

    Sedgwick (Raleigh, NC)
    …and client satisfaction; to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for ... business lines; and to provide expertise in client specific case management and utilization review ...promote maximum performance. **QUALIFICATIONS** **Education & Licensing** Current unrestricted RN license in a state or territory of the… more
    Sedgwick (06/29/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (Raleigh, NC)
    …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
    Prime Therapeutics (07/24/25)
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  • Clinical Liaison Rehab Services

    UNC Health Care (Rocky Mount, NC)
    …reviews for private insurance companies, Medicare and Medicaid, in accordance with utilization review guidelines. 2. Reviews assigned patients' cases prior to, ... Professional Experience Requirements: * 2 years' experience in Healthcare/Medical - Registered Nurse . **Job Details** Legal Employer: Nash Hospitals Entity:… more
    UNC Health Care (07/24/25)
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