Top 8 Utilization review nurse Jobs in Morehead City 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
UR Clinical Associate
Carteret Health Care —Morehead City, NC
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Physical & Rehabilitation Medicine
Quick Apply

More jobs to discover

Find similar jobs that you might be interested in.

RN Case Manager
Carteret Health Care —Morehead City, NC
Registered nurse with current North Carolina license (BSN preferred). Conduct a comprehensive assessment and develop thoughtful plans to implement, coordinate,…
Registered Nurse Care Manager
Coastal Carolina Health Care, P.A. —Morehead City, NC
Licensure - Active, unrestricted Registered Nurse (RN) license in the state of NC. The RN Care Manager is a key member of the primary care team, focusing on the…
$60,000 - $70,000 a year
Quick Apply
1d

Show more similar jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
Registered Nurse Care Coordinator - Fostering Connections Clinic (PFK)
Nationwide Children's Hospital —Columbus, OH
Valid Ohio driver’s license and proof of auto insurance as required by hospital policy. Pediatric certification, Advanced-Continuity of Care Certification (A-…
6d

Show more jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in morehead city nc

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization review nurse jobs near morehead city nc

Registered Nurse Case Manager jobs in Cherry Point, NC

Registered Nurse jobs in Richland, WA

Registered Nurse Case Manager jobs in Janesville, WI

Registered Nurse Case Manager jobs in New Braunfels, TX

Emergency Nurse Practitioner jobs in New Jersey

Registered Nurse jobs in Orland Park, IL

Registered Nurse Case Manager jobs in Maple Valley, WA

Registered Nurse Case Manager jobs in Virginia Beach, VA

Part Time Registered Nurse jobs in Fort Wayne, IN

Clinical Associate jobs in Queens, NY

Clinical Associate jobs in Pittsburgh, PA

Clinical Associate jobs in Morgantown, WV

Masters Degree Clinical Mental Health Counseling jobs in New Jersey

Staff Research Associate jobs in California

Clinical Pharmacist jobs in Pittsburgh, PA

Associate Underwriter jobs in California

Clinical Associate jobs in Corona, CA

Registered Nurse Case Manager jobs in Suffolk, VA

Registered Nurse Case Manager jobs in Hingham, MA

Outpatient Clinic Nurse jobs in Miami, FL

RN Case Manager

Carteret Health Care -
Morehead City, NC

Apply Now

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 review nurse jobs in morehead city nc

RN Case Manager

Registered Nurse - Case Manager

UR Clinical Associate

More jobs to discover

Explore jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in morehead city nc

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected