Case Manager/Utilization Review, RN
4 weeks ago
Position Information:
The Nurse Case Manager is a Registered Nurse responsible for providing patient case management services to assigned populations. Utilizes a collaborative interdisciplinary approach to anticipate integrate and coordinate the patient's plan of care discharge plan and re-entry into the community. In collaboration with the treatment team the nurse case manager identifies at risk patient populations who require patient case management services.Provides bio-psychosocial assessments assists patients with self-management skills educational materials advocacy resources and/or support groups so they can be full participants in their treatment and recovery. The nurse case manager serves as a patient/family advocate and acts as a communication link between the physician patient family health care team community resources and payors to reduce redundancy and fragmentation of care. Anticipates potential delays in the health care process and acts pro-actively to avoid these delays. Reviews and assesses appropriateness of patient admission/continued stay. Completes concurrent reviews and monitors the use of insurance benefits to maximize service to patients. Provides timely pertinent insurance benefits information to clinical staff so that they will provide care within patients? benefits package and thereby optimize third party payment for services. Assists physicians in preparing appeals when payment has been denied by insurance companies. Assists in the implementation of the Hospital Utilization Review Plan. Provides consultation and/or education to clinical staff regarding monitoring studies and medical records reviews. Participates in the preparation and tracking of the Involuntary Commitment processes and represents the hospital in involuntary hearings process.
Experience Requirements:
3 Years Nursing - Related Area Required - And 5 Years Nursing - Related Area Preferred In Clinical - Case Management Or Clinical - Discharge Planning Or Accounting/Finance - Third Party Review Or Clinical - Home or Community Health Preferred
Select Education Type:
Graduate Nursing Required - And Bachelor's Degree Required - In Nursing Preferred
Licensure/Certification Requirements:
Registered Nurse Required - And Certified Case Manager Or Commission for Case Management Certification Required - Within 1 Year of Hire And Certified Notary Required - Within 1 Year of Hire
Hours of Work:
Saturday & Sunday, 6:45am-5:15pm
Weekend Requirements:
Every Weekend
Call Requirements:
None
-
Case Manager RN
6 days ago
Raleigh, United States CVS Pharmacy Full timeBring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing w Case Manager, Manager, RN, Medical Director, Health, Retail, Healthcare, Program
-
RN Case Manager, Alamance County
17 hours ago
Raleigh, United States Well Care Home Health of the Triangle, Inc. Full timeWell Care Health is a 5-star rated agency for quality of patient care, and nationally ranked in the top 10% of agencies. We are seeking passionate, full-time, RN Case Managers for our weekday team in Alamance County.Work for the best. Learn from the best. Be the best.The Home Health Registered Nurse uses an individualized patient care plan to provide top...
-
Document review Paralegal
4 weeks ago
Raleigh, United States Ave Staffing Legal Specialists Full timeJob DescriptionJob DescriptionWe are seeking a highly motivated and detail-oriented Document Review Paralegal to join a growing mass torts team in Raleigh. In this role, you will play a critical role in the discovery process by efficiently and accurately reviewing and analyzing large volumes of documents for potential evidence relevant to our clients'...
-
RN Case Manager Home Health
17 hours ago
Raleigh, United States Well Care Home Health of the Triangle, Inc. Full timeWell Care Home Health is hiring a Registered Nurse (RN) Case Managers for our Home Health patients in Durham County to join our growing team of clinicians! This position also comes with a $10,000 sign-on agreement!Our RN Case Managers deliver one-on-one care to patients inside the comfort of their own homes. Join the best Home Health care agency in the Tar...
-
RN Case Manager, Alamance County
4 days ago
Raleigh, NC, United States Well Care Home Health of the Triangle, Inc. Full timeWell Care Health is a 5-star rated agency for quality of patient care, and nationally ranked in the top 10% of agencies. We are seeking passionate, full-time, RN Case Managers for our weekday team in Alamance County.Work for the best. Learn from the best. Be the best.The Home Health Registered Nurse uses an individualized patient care plan to provide top...
-
BH Care Manager I
7 days ago
Raleigh, United States Elevance Health Full timeA proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of...
-
RN Clinical Manager, Home Health
3 days ago
Raleigh, United States CenterWell Home Health Full time**Please Note: There is a $10K sign-on bonus associated with this role**Work Schedule: Full-time/40 HoursPosition Type: On-siteBranch Location: Raleigh, NCThis is not a remote or work-from-home position.The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel.Develops, plans, implements, analyzes, and...
-
Case Manager/Counselor- Shelter
2 days ago
Raleigh, United States InterAct Full timeJob Type Full-timeDescriptionEach member of InterAct's staff fulfills an important role in furthering InterAct's mission of saving lives, rebuilding lives, and securing safer futures. The Case Manager/Counselor provides on-site coverage and case management/counseling services to residents in residential program. These services include, but are not limited...
-
RN Case Manager Home Health
4 days ago
Raleigh, NC, United States Well Care Home Health of the Triangle, Inc. Full timeWell Care Home Health is hiring a Registered Nurse (RN) Case Managers for our Home Health patients in Durham County to join our growing team of clinicians! This position also comes with a $10,000 sign-on agreement!Our RN Case Managers deliver one-on-one care to patients inside the comfort of their own homes. Join the best Home Health care agency in the Tar...
-
Engineering / Utility Coordinator
3 weeks ago
Raleigh, United States Pennoni Full timeJob Description Pennoni is a multidisciplinary consulting engineering firm founded more than five decades ago. We approach engineering challenges from a wider spectrum of angles than most, from land development to energy management. Our goal is to help communities and private sector clients alike navigate the ever-changing technological advancements...
-
Engineering / Utility Coordinator
3 days ago
Raleigh, North Carolina, United States Pennoni Full timePennoni is a multidisciplinary consulting engineering firm founded more than five decades ago. We approach engineering challenges from a wider spectrum of angles than most, from land development to energy management. Our goal is to help communities and private sector clients alike navigate the ever-changing technological advancements available and learn how...
-
Engineering / Utility Coordinator
19 hours ago
Raleigh, United States Pennoni Full timePennoni is a multidisciplinary consulting engineering firm founded more than five decades ago. We approach engineering challenges from a wider spectrum of angles than most, from land development to energy management. Our goal is to help communities and private sector clients alike navigate the ever-changing technological advancements available and learn how...
-
Refugee Case Manager
5 days ago
Raleigh, United States Lutheran Services Carolinas Full timeJob DetailsJob Location LSC Raleigh Office - Raleigh, NC Salary Range $22.00 - $23.00 Hourly Refugee Case Manager The objective of the Reception and Placement Case Manager position is to ease client's transition to life in the US and assist them along the path to self-sufficiency. The R&P Case Manager will provide extensive case management to newly arriving...
-
Senior Utilities Financial Analyst
2 weeks ago
Raleigh, United States Booth & Associates, LLC Full timeJob Type Full-time Description We are seeking a qualified individual for a senior position that will move toward leading the Financial Services Department. Occupational Summary: This position will support the Financial Services Department in providing professional accounting and financial-related advisory services to municipal utilities and electric...
-
Senior Utilities Financial Analyst
3 weeks ago
Raleigh, United States Booth & Associates LLC Full timeJob DescriptionJob DescriptionDescription:We are seeking a qualified individual for a senior position that will move toward leading the Financial Services Department.Occupational Summary:This position will support the Financial Services Department in providing professional accounting and financial-related advisory services to municipal utilities and electric...
-
RN Clinical Manager, Home Health
3 days ago
Raleigh, NC, United States CenterWell Home Health Full time**Please Note: There is a $10K sign-on bonus associated with this role**Work Schedule: Full-time/40 HoursPosition Type: On-siteBranch Location: Raleigh, NCThis is not a remote or work-from-home position.The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel.Develops, plans, implements, analyzes, and...
-
Clean Utilities Engineer PQ LEAD
1 week ago
Raleigh, United States MMR Consulting Full timeJob DescriptionJob DescriptionSalary: MMR Consulting is an engineering and consulting firm specializing in the pharmaceutical, and biotechnology industries in the US and Canada. Its services include Engineering, Project Management, and other Consulting services. MMR’s Engineering expertise includes Process, Automation, Facilities engineering....
-
Dry Utilities Manager
2 weeks ago
Raleigh, North Carolina, United States Timmons Group Full timeJob Description Timmons Group is seeking an experienced Dry Utilities Manager for our Urban Land Development Group located in our Raleigh, NC office. Civil engineering experience and dry utility construction experience preferred. The qualified candidate must be able to perform all aspects of dry utility plan preparation and permit procurement. The...
-
Case Administrator/Courtroom Deputy
4 weeks ago
Raleigh, United States North Carolina Eastern District Court Full timeMain content Job Details for Case Administrator/Courtroom Deputy (Civil) Court Name/Organization: North Carolina Eastern District Court Overview of the Position: The U.S. District Court for the Eastern District of North Carolina is seeking qualified applicants for a full-time, temporary Civil Case Administrator/Courtroom Deputy. This position performs...
-
RN Unit Manager
19 hours ago
Raleigh, United States NCG Associates Full timeNCG Associates is a reputable healthcare staffing agency dedicated to providing exceptional nursing professionals to healthcare facilities nationwide. We are currently seeking an experienced and dedicated Registered Nurse (RN) Unit Manager to join our team. As an RN Unit Manager at NCG Associates, you will play a critical role in overseeing the daily...