Talent.com
LA Licensed Clinical Review Nurse

LA Licensed Clinical Review Nurse

VirtualVocationsRaleigh, North Carolina, United States
job_description.job_card.1_day_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for a Clinical Review Nurse - Concurrent Review.

Key Responsibilities

Perform concurrent reviews to determine overall health and appropriate level of care for members

Review quality and continuity of care, including acuity level and discharge planning

Collaborate with healthcare providers and Medical Affairs to discuss member care and provide recommendations

Required Qualifications, Training, and Education

Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing

2 - 4 years of related experience, with 2+ years of acute care experience required

Knowledge of Medicare and Medicaid regulations preferred

Knowledge of utilization management processes preferred

LPN - Licensed Practical Nurse - State Licensure required

serp_jobs.job_alerts.create_a_job

Clinical Review Nurse • Raleigh, North Carolina, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Clinical Review Nurse - Concurrent Review

Clinical Review Nurse - Concurrent Review

Spectraforce TechnologiesRaleigh, NC, United States
serp_jobs.job_card.full_time
Clinical Review Nurse - Concurrent Review.Monday through Friday, 9 : 30 AM to 6 : 00 PM CST.Performs concurrent reviews, including determining member's overall health, reviewing the type of care being ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Maryland Licensed Clinical Appeals Nurse

Maryland Licensed Clinical Appeals Nurse

VirtualVocationsDurham, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals Nurse (Remote).Key Responsibilities Investigates and analyzes written appeals and reconsideration requests, responding with detailed letters while adhe...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
RN Clinical Nurse-II - ED Clinical Decision Unit

RN Clinical Nurse-II - ED Clinical Decision Unit

UNC HealthRaleigh, North Carolina, United States
serp_jobs.job_card.full_time
This position qualifies for our UNC Rex Incentive Program, which includes up to $20,000 commitment incentive.In addition, this position is also eligible for up to $10,000 in relocation assistance (...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
HOSPICE LICENSED PRACTICAL NURSE

HOSPICE LICENSED PRACTICAL NURSE

Liberty Healthcare ManagementDunn, NC, US
serp_jobs.job_card.full_time
That is why Liberty Hospice provides our hospice patients with state-of-the-art care and pain management services, delivered by our specially trained staff with emphasis on strength, dignity and co...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
New York Licensed Clinical Review Nurse

New York Licensed Clinical Review Nurse

VirtualVocationsDurham, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse.Key Responsibilities Perform Utilization Review activities in accordance with jurisdictional guidelines Assess medical necessity and appropriaten...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Texas Licensed Clinical Nurse Director

Texas Licensed Clinical Nurse Director

VirtualVocationsRaleigh, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Director of Utilization Management.Key Responsibilities Develop and implement strategic plans for Utilization Management aligned with organizational goals Direct all U...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Wisconsin Licensed Clinical Review Nurse

Wisconsin Licensed Clinical Review Nurse

VirtualVocationsRaleigh, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Prior Authorization.Key Responsibilities Analyze prior authorization requests to determine medical necessity and appropriate level of care Coor...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
California Licensed Review Nurse

California Licensed Review Nurse

VirtualVocationsRaleigh, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Pre-Service Review Nurse RN to work remotely in the Pacific or Mountain Time Zones.Key Responsibilities Conduct utilization management, including Prior Authorization Re...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
RN Clinical Nurse II - Isolation

RN Clinical Nurse II - Isolation

Nash UNC Health CareRaleigh, NC, US
serp_jobs.job_card.full_time
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Provides competent clinical nur...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Travel Nurse RN - $1,424 to $1,624 per week in Lillington, NC

Travel Nurse RN - $1,424 to $1,624 per week in Lillington, NC

TravelNurseSourceLillington, NC, US
serp_jobs.job_card.full_time
TravelNurseSource is working with Ventura MedStaff to find a qualified Other RN in Lillington, North Carolina, 27546!.Are you ready to take your Travel career to the next level? See places you hav...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
North Carolina Licensed Clinical Nurse

North Carolina Licensed Clinical Nurse

VirtualVocationsRaleigh, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a RN Clinical Nurse II - Nurse Connect.Key Responsibilities Participates in patient education and assesses readiness to learn Evaluates patient care outcomes and communi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
North Carolina Licensed Clinical Resource Nurse

North Carolina Licensed Clinical Resource Nurse

VirtualVocationsDurham, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a HSPC Clinical Resource Nurse.Key Responsibilities Ensures appropriate clinical pathways are assigned on the plan of care Completes daily oversight of the Muse system f...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
State Licensed Clinical Content Reviewer

State Licensed Clinical Content Reviewer

VirtualVocationsRaleigh, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Content Editor - PGY-1 / Medical Students.Key Responsibilities Collaborate with a multidisciplinary team to create and curate content on emerging medical technol...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Tennessee Licensed Clinical Review Manager

Tennessee Licensed Clinical Review Manager

VirtualVocationsRaleigh, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Manager to oversee medical reviews for utilization management.Key Responsibilities Initiate referrals for appropriate coordination of care Assist in co...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Liaison Nurse

Clinical Liaison Nurse

BrightSpring Health ServicesRaleigh, NC, US
serp_jobs.job_card.full_time
Specialty Infusion services—we’re building relationships that improve patient outcomes and drive business success.As a national leader in home infusion therapy, we empower our Clinical ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
RN Clinical Nurse (Per Diem)-Critical Care

RN Clinical Nurse (Per Diem)-Critical Care

Nash UNC Health CareRaleigh, NC, US
serp_jobs.job_card.full_time
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Provides competent clinical nur...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
LA Licensed Clinical Review Nurse

LA Licensed Clinical Review Nurse

VirtualVocationsDurham, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Perform concurrent reviews to determine overall health and appropriate level of care for members Review ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
RN Clinical Nurse II-MTSU

RN Clinical Nurse II-MTSU

Nash UNC Health CareDurham, NC, US
serp_jobs.job_card.full_time
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. UNC Health Nash, an affiliated ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Hawaii Licensed Review Nurse RN

Hawaii Licensed Review Nurse RN

VirtualVocationsDurham, North Carolina, United States
serp_jobs.job_card.full_time
A company is looking for a Preservice Review Nurse RN - Remote in Hawaii.Key Responsibilities Assess and interpret customer needs and requirements Identify solutions to non-standard requests and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Clinical Nurse IV Leader - Peds Transplant and Cellular Therapy / Oncology

Clinical Nurse IV Leader - Peds Transplant and Cellular Therapy / Oncology

Duke HealthDurham, North Carolina, United States
serp_jobs.job_card.full_time
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and disc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30