Top 16 Utilization management nurse Jobs in Cherry Point, Nc

RN Case Manager
Carteret Health Care —Morehead City, NC
- Full-time
- Nursing
- RN License
- Hospital
Registered Nurse - Case Manager
ERP International —Cherry Point, NC
- Online Application
- Background check
- Nursing
- RN License
- Health savings account
- Paid holidays
Care Manager - LP (Vance County, NC)
Vaya Health —North Carolina
- $62,993.80 - $81,891.99 a year
- Full-time
- LMFT
- Nursing
- Microsoft Excel
Care Manager - LP (Rowan County, NC)
Vaya Health —North Carolina
- $62,993.84 - $75,000.00 a year
- Full-time
- LMFT
- Nursing
- Microsoft Excel
SCHOOL NURSE
Craven County Schools —New Bern, NC
- From $20.39 an hour
- Full-time
- Classroom
- Nursing
- Management
Hospice Nurse, RN
3HC HOME HEALTH & HOSPICE CARE INC —Pollocksville, NC
- Full-time
- CPR Certification
- Nursing
- RN License
- Continuing education credits
Quick Apply
SCHOOL NURSE - SUBSTITUTE
Craven County Schools —New Bern, NC
- From $20.39 an hour
- Full-time
- Nursing
- RN License
- Research
EXCEPTIONAL CHILDREN - CHILD SPECIFIC LPN
Craven County Schools —New Bern, NC
- Full-time
- School experience
- Classroom
- CPR Certification

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RN Home Health/Hospice Clinical Operations Mgr
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utilization management nurse jobs near cherry point, nc

RN Case Manager

Carteret Health Care -
Morehead City, NC

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Job Details

Full-time

Qualifications

Computer operation
RN License
BLS Certification
Healthcare Provider Certification
Hospital experience

Full Job Description

JOB RELATIONSHIPS
- Reports to the Director of Research and Innovation in collaboration with the CNO/VP of Patient Care
  Services
DEFINITION OF POSITION
- The Registered Nurse (RN) Care Manager will:
  
  Conduct a comprehensive assessment and develop thoughtful plans to implement, coordinate, monitor,
  and evaluate healthcare services tailored to meet each individual’s specific needs in a cost-effective
  manner.
  
  Perform utilization reviews to assess the appropriateness and medical necessity of healthcare services
  for patients, while fostering strong relationships with payers to ensure compliance and alignment.
  
  Foster strong relationships with payers to ensure compliance and alignment
  
  Act as a patient advocate to guide patients through the complex healthcare system, ensuring their
  preferences and rights are respected and helping them access appropriate care or coverage
  
  Facilitate coordinated patient care by collaborating with patients, their families, healthcare staff,
  physicians, Advanced Practice Provider (APPs) and community services, all aimed at promoting quality
  care.
  
  Incorporate cultural competence and awareness of Social Determinants of Health (SDOH) into assessment
  and care plan development to ensure a holistic approach to patient well-being
  
  Take the lead on discharge planning and care coordination initiatives, with the goal of minimizing
  readmissions.
  
  Work closely with interdisciplinary teams to create and refine patient-centered care plans.
  
  Regularly monitor key performance indicators (KPIs), such as length of stay and readmission rates, to
  ensure optimal service delivery.
  
  Uphold stringent adherence to guidelines established by CMS, the Joint Commission, and all relevant
  payer requirements.
QUALIFICATIONS
- Professional
  - Registered nurse with current North Carolina license (BSN preferred).
  - Current BLS Healthcare Provider certification.
  - Three years clinical experience in a health care facility with knowledge base of clinical nursing principles
  - Case Management Certification (CCM), Accredited Case Manager (ACM) and/or Health Care Quality and Management (HCQM) certification preferred
  - Knowledge of current trends and issues related to utilization and case management principles related to the hospital practice setting.
  - Computer experience
  - Evidence of participation in ongoing continuing education programs.

Location: Carteret Health Care · Case Management
Schedule: Full-time, Days, 40

Apply Now

Refine Your Search

utilization management nurse jobs in cherry point, nc

RN Case Manager

Registered Nurse - Case Manager

Care Manager - LP (Vance County, NC)

Care Manager - LP (Rowan County, NC)

SCHOOL NURSE

Hospice Nurse, RN

SCHOOL NURSE - SUBSTITUTE

EXCEPTIONAL CHILDREN - CHILD SPECIFIC LPN

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