- ERP International (Camp Lejeune, NC)
- …and general hospital procedures and regulations. Collaborates with TRICARE Regional Office Clinical Liaison Nurse and MTF Liaison to address any process ... full-time **Licensed Practical** **/Vocational Nurses (LPN/LVN)** in support of Referral Management Center at theNaval Medical Center Camp Lejeune, NC. Apply online… more
- Teleflex (Charlotte, NC)
- …market today, from our world-class brands including: + LMA and Rusch airway management devices designed to help reduce the risk of airway-related complications. + ... Arrow pain management products designed to improve patients' post-operative pain experience. Join a dynamic, growing team that offers healthcare providers advanced… more
- CVS Health (Raleigh, NC)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Cognizant (Raleigh, NC)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical … more
- Humana (Raleigh, NC)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Raleigh, NC)
- … (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all ... and state regulated turn-around times. This includes reviewing written clinical records. **Key Responsibilities of the UM Nurse...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
- Brighton Health Plan Solutions, LLC (NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... member's benefit coverage while working remotely. Primary Responsibilities * Performs clinical utilization reviews using evidenced based guidelines, policies and… more
- CVS Health (Raleigh, NC)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- UNC Health Care (Kinston, NC)
- …and well-being of the unique communities we serve. **Summary:** This position facilitates utilization management processes to support the right care is provided ... the right place at the right time. To accomplish these goals, the UR, Nurse applies established criteria to evaluate the appropriateness of admission, level of care,… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- … Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non- Clinical support staff. The ideal candidate ... will have a strong clinical background within a managed care setting including a...Responsibilities + Coordinate day to day operations of the Utilization Management team. + Serve as the… more
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