- UNC HEALTH (Raleigh, NC)
- …care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly ... from CAPP as appropriate. As necessary meet with the Utilization Manager (UM) and SW after the meeting to...patient needs and concerns through scheduled touch points and review of documentation . Escalate urgent or complex… more
- UNC Health Care (Chapel Hill, NC)
- …episode through post discharge for quality, efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ... are met and care delivery is coordinated across the continuum. The Utilization Manager completes admission, continued stay, and discharge reviews in accordance with… more
- UNC Health Care (Hendersonville, NC)
- … reviews in accordance with federal regulations and the health system's Utilization Review Plan. Responsibilities: + Uses approved criteria and conducts ... the health and well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and discharge review … more
- CVS Health (Raleigh, NC)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- KBR (Fayetteville, NC)
- …compliance in meeting care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... Title: Special Operations Nurse Case Manager (JFKSWC, Fort Bragg, NC) THIS...Demonstrated knowledge of patient education principles and management of complex medical, psychosocial, and financial problems in order to… more
- Prime Therapeutics (Raleigh, NC)
- …clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + At minimum must ... drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing referral… more
- KBR (Fayetteville, NC)
- …compliance in meeting care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... Title: Special Operations Nurse Case Manager / Case Manager (JSOC, Fort...Demonstrated knowledge of patient education principles and management of complex medical, psychosocial, and financial problems in order to… more
- UNC Health Care (Raleigh, NC)
- …care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager must be highly ... from CAPP as appropriate. As necessary meet with the Utilization Manager (UM) and SW after the meeting to...patient needs and concerns through scheduled touch points and review of documentation . Escalate urgent or complex… more
- Lowe's (Mooresville, NC)
- …and claims administrator to close gaps and increase temporary transitional duty utilization . Will function as project lead on process flow design and analysis ... strategies for optimal or early resolution. + Works cross-functionally to review and revise litigation management guidelines, and Request for Proposal Documents,… more
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