A leading healthcare provider in Winston Salem, North Carolina is looking for an Advanced Practice Provider in Neurosurgery Spine. This role involves providing comprehensive care to patients with neurosurgical spine conditions and requires collaboration with multidisciplinary teams. Candidates should hold a relevant nursing or physician assistant degree, have a valid state license, and ideally possess experience in primary care. The position offers competitive compensation and a flexible work-life balance.
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$38k-61k yearly est. 4d ago
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Telehealth Nurse
Actalent
Utilization review nurse job in Cary, NC
We are seeking a dedicated Telehealth Registered Nurse to counsel and educate patients on specialty drug therapies, ensuring adherence to contracted and accrediting regulations. This role involves thorough and accurate documentation, discussing side effects with patients, and identifying and reporting adverse events and product complaints to the relevant authorities.
Responsibilities
+ Counsel and educate new and existing patients on specialty drug therapies.
+ Ensure adherence to contracted and accrediting regulations as indicated by drug specification.
+ Complete thorough and accurate documentation using good documentation practices and compliance with industry standards and regulations.
+ Discuss potential and current side effects with patients to educate them about treatment alternatives and facilitate ongoing therapy adherence.
+ Identify and report adverse events and product complaints to the manufacturer, FDA, and/or other governing authorities.
Essential Skills
+ Telehealth expertise.
+ Triage and acute care experience.
+ Oncology nursing experience.
+ Registered Nurse (RN) license.
+ Utilization management skills.
+ Patient education proficiency.
+ Must be an RN licensed in North Carolina with a multi-state compact nursing license.
+ At least 5 years of nursing experience.
Additional Skills & Qualifications
+ Associate, Bachelor, or higher in Nursing or accredited nursing diploma.
+ Graduate of an accredited school of nursing with 3-5 years or more post-graduate experience in pharmacy operations and patient care.
+ 5 or more years of nursing experience with at least 1 year of acute inpatient care preferred.
+ Ability to obtain licensing in all states and United States territories serviced within 3 months of employment.
+ Proficient in computer skills including e-mail, word processing, spreadsheet, and web-based programs.
+ Effective communication skills, both oral and written.
+ Experience with motivational interviewing is preferred.
+ Ability to read, analyze, and interpret practice standards, professional journals, technical procedures, and government standards and regulations.
Work Environment
You will work with a large healthcare leader within patient care and access. The working hours are Monday to Friday, from 9 am to 6 pm, with a 1-hour lunch break. The position requires a valid North Carolina multi-state nursing license with no restrictions. OSW will be trained with a preceptor and will have the opportunity to participate in various work activities.
Job Type & Location
This is a Contract to Hire position based out of Cary, NC.
Pay and Benefits
The pay range for this position is $41.00 - $41.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a hybrid position in Cary,NC.
Application Deadline
This position is anticipated to close on Jan 29, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.
$41-41 hourly 4d ago
SUPPORT NURSE (LPN) - BERMUDA COMMONS
Liberty Health 4.4
Utilization review nurse job in Advance, NC
Liberty Cares With Compassion
At Liberty Healthcare and Rehabilitation Services, we promote a challenging, but rewarding opportunity in a caring environment.
We are currently seeking an experienced: SUPPORT NURSE - LPN
Job Description:
Assist in assuring the best patient care possible by assisting nursing personnel (including charge nurse and Director of Nursing) on a specified unit during their assigned work hours.
May be required to take call for staffing coverage.
Assist in providing resident care, in accordance with the Nursing Practice Act, and under the supervision of a Registered Nurse.
Delegates duties to non-licensed nursing personnel and monitoring performance under the supervision of a Registered Nurse and assists in preparation of a work schedule as needed.
Assist in Quality Assurance data collection for analysis and corrective action implementation by the Quality Assurance Nurse.
Assist with infection control for unit.
Adheres to all regulations pertaining to cleanliness, infection control and Standard Precaution.
Assist with records, orders, and assessment of new admissions to the unit. Assist with assuring the initial nursing assessment is completed.
Completed assigned resident assessments as assigned by MDS Nurse or Director of Nursing.
Attends Nurse Department meetings as scheduled.
Assist with monitoring and measuring decubiti weekly and completing integument watch assessment forms accurately and works with other departments to implement needs for the unit and needs of patients on the unit.
Reports any possible performance issues by employees within the facility to the RN for determination if disciplinary action is required. May be asked by the RN to send an employee home for the remainder of the shift if the RN determines that further investigation is needed. May document the performance concern on the appropriate form for review and use by the RN in the disciplinary process.
Assist with lab request as ordered per facility policy using appropriate techniques. Responsible for reposting lab work as ordered on unit, reviewing results and notifying attending MD per established policies, protocols, and physician orders.
Assist with emergencies arising while on duty. Performs CPR if needed. Assist with emergencies on other units if needed.
Assist with notifying attending MD of any change or illness of patients in the unit. Notifies attending physician of emergencies and death of patients in the unit. Implement order of changes in orders as instructed or ordered by MD.
Assist with other general duties which include rounds with doctors; checking MD orders, including update of orders; verification of completeness of nursing summaries timely and verification that all nursing records are complete and timely.
May be asked to provide hall coverage as needed.
Assist with coordinating the health care team including the rehab aides duties and assignments.
Other duties as assigned by Director of Nursing in accordance to NC Board Of Nursing Practice Acts.
Job Requirements:
Must be a high school graduate
Must be a Licensed Practical Nurse (LPN) graduated from an accredited School of Nursing, with a current, valid license as a Licensed Practical Nurse in North Carolina and submit proof of license renewal.
Must provide quality-nursing care to patients, follow doctor's orders, and have a genuine interest in geriatric nursing.
Must be CPR certified yearly and attend in-service training and other staff meetings as required.
Must have ability to make decisions regarding nursing and unit problems realizing that errors and incompetence may have serious consequences for patients and/or staff.
Must be able to work well under pressure, problem solve, and perform various jobs.
Must read, know and follow personnel, department and facility policies and procedures and adhere to local, state and federal requirements.
Must be able to maneuver medication carts, treatment carts and other nursing equipment.
Visit ********************************* for more information.
Background checks/drug-free workplace.
EOE.
PI7b93cd8c752f-37***********9
$41k-57k yearly est. 7d ago
Utilization Management Nurse
Centerwell
Utilization review nurse job in Raleigh, NC
**Become a part of our caring community and help us put health first** Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole.
Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others.
**Preferred Locations:** Daytona, FL, Louisville, KY, San Antonio, TX
**Use your skills to make an impact**
**Role Essentials**
+ Active Unrestricted RN license
+ Possession of or ability to obtain Compact Nursing License
+ A minimum of three years clinical RN experience;
+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience
+ Demonstrates Emotional Maturity
+ Ability to work independently and within a team setting
+ Valid driver's license and/or dependable transportation necessary
+ Travel for offsite Orientation 2 to 8 weeks
+ Travel to offsite meetings up to 6 times a year as requested
+ Willing to work in multiple time zones
+ Strong written and verbal communication skills
+ Attention to detail, strong computer skills including Microsoft office products
+ Ability to work in fast paced environment
+ Ability to form positive working relationships with all internal and external customers
+ Available for On Call weekend/holiday rotation if needed
**Role Desirables**
+ Education: BSN or bachelor's degree in a related field
+ Experience with Florida Medicaid
+ Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures
+ Compact License preferred
+ Previous experience in utilization management within Insurance industry
+ Previous Medicare Advantage/Medicare/Medicaid Experience a plus
+ Current nursing experience in Hospital, SNF, LTAC, DME or Home Health.
+ Bilingual
**Additional Information**
We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more.
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 02-18-2026
**About us**
About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
$71.1k-97.8k yearly 5d ago
Utilization Review & Revenue Cycle Management
Advaita Health
Utilization review nurse job in Raleigh, NC
Job Description
About Us
Advaita Health is committed to a sustainable, integrated model of behavioral healthcare where providers, staff, and patients thrive. Our clinical and operational teams work hand-in-hand, ensuring patients receive the best possible care while critical behind-the-scenes processes, like revenue cycle management, are handled with accuracy and integrity. Every role at Advaita Health contributes to our mission of delivering high-quality, accessible behavioral health services-and our revenue cycle team plays an essential part in supporting both our patients and our financial health.
Our goal for you is simple: to create a place where you can build a lasting career, maintain balance, and perform meaningful work without burning out. We support this through:
Workloads and expectations that protect time for accuracy and growth
Mentorship, training, and leadership development
Performance measures based on values and competencies, not just numbers
Built-in collaboration and transparency across teams
Technology that supports efficiency rather than obstructs it
Why Join Advaita Health?
Full-time, hourly, non-exempt position
Opportunity to work closely with clinical, administrative, and finance teams
401(k) with employer match
3 weeks of PTO and 10 paid federal holidays
Flexible health, dental, and vision coverage; HSA/FSA options
Free life insurance up to $10,000; short- and long-term disability coverage
Employee Assistance Program (EAP) with therapy and financial support
What We're Looking For
We're seeking a UtilizationReview & Revenue Cycle Coordinator who is detail-oriented, organized, and proactive-someone who understands the importance of payer compliance, authorization management, and clean revenue cycle processes in behavioral health and substance use disorder services.
This role has a primary focus on utilizationreview activities, including insurance verification, authorization tracking, and clinical reviews, while also supporting key revenue cycle functions such as claims follow-up and denial resolution. Success in this role requires strong communication skills, the ability to interpret clinical and billing documentation, and a collaborative mindset.
You'll thrive here if you're someone who:
Enjoys working cross-functionally with clinical and administrative teams
Takes ownership of processes and follows through on details
Values accuracy, compliance, and professionalism
Wants to contribute to systems that support both patient care and organizational sustainability
Key Responsibilities
Track and manage authorizations, units, and levels of care in accordance with payer guidelines
Verify insurance benefits and authorization requirements prior to enrollment
Submit authorization requests and clinical reviews using appropriate documentation and criteria (including ASAM, when applicable)
Resolve authorization denials and partial approvals in collaboration with clinical leadership
Support revenue cycle operations, including claims submission, denial follow-up, and reimbursement tracking
Communicate with insurance carriers to resolve authorization and billing discrepancies
Maintain accurate documentation and ensure HIPAA and regulatory compliance
Qualifications
Bachelor's degree in Healthcare Administration, Business, or a related field-or equivalent experience
Working knowledge of utilizationreview and revenue cycle workflows
Experience with insurance verification, authorizations, and claims follow-up
Strong organizational skills and attention to detail
Professional, dependable, and collaborative
Preferred Experience
1-3 years of experience with insurance denials and appeals
Familiarity with ASAM criteria and managed care requirements
Experience in behavioral health and/or substance use disorder billing
Experience with EMR systems (AdvancedMD preferred)
We don't expect long hours, but we do expect professionalism, engagement, and a willingness to learn.
Ready to Join Us?
If you're looking for more than just a job-if you want a career where your expertise supports patients, providers, and the sustainability of behavioral healthcare-we'd love to hear from you.
$44k-69k yearly est. 11d ago
Utilization Review Nurse (RN)
Integrated Resources 4.5
Utilization review nurse job in Raleigh, NC
A Few Words About Us - Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Job Description
· The incumbent must possess medical management/clinical decision-making skills and sound skills in assessing, planning and managing member care.
· Advanced assessment and teaching skills.
· Problem solving skills.
· Familiarity with legal terminology and liability issues and ability to handle ethical or risk management issues.
· Utilization and Quality Management/Outcomes experience preferred.
· Previous work experience with a managed care organization or provider is also preferred.
· Prior experience in case management, home health, discharge planning, or Concurrent review.
Qualifications
· RN Diploma, RN Associate's degree or Bachelors of Science in Nursing (BSN) degree.
· Minimum of 3 years clinical experience in an acute medical or acute surgical setting.
· Proficiency with a Microsoft Windows operating system.
· Must have valid license to practice nursing within the US and have started application for NCnursing license.
Additional Information
With Regards,
Kavita Kumari
Allied Healthcare Recruiter
Integrated Resources, Inc
IT REHAB CLINICAL NURSING
Inc. 5000 - 2007-2014 (8th Year)
Certified MBE I GSA - Schedule 66 I GSA - Schedule 621I I GSA - Schedule 70
Tel: 732-549-2030 x208
Fax: 732-549-5549
Direct: 732-549-5302
$58k-74k yearly est. 1d ago
Staff Nurse - WOW
Novant Health 4.2
Utilization review nurse job in Wilmington, NC
What We Offer:
The Registered Nurse serves as a leader of the healthcare team at Novant Health by establishing an authentic personalized relationship with the patient and their chosen support system, collaborating with physicians and other team members to assess, plan, implement, and evaluate an individualized plan of care that promotes optimal health or supports a peaceful death. The Registered Nurseutilizes best scientific evidence and compassion to assist the patient in navigating their health journey. The Registered Nurse accepts responsibility, authority, and accountability for management and provision of care in accordance with the current policies and procedures.
What We're Looking For:
Graduate of an accredited school of nursing required.
Associate's or Bachelor's degree in nursing.
Current valid North Carolinanursing license required.
Basic Life Support (BLS) through American Red Cross or American Heart Association required.
One-year of acute nursing experience required.
$52k-62k yearly est. 1d ago
Nurse Case Manager
GD Information Technology
Utilization review nurse job in North Carolina
Type of Requisition:
Regular
Clearance Level Must Currently Possess:
Top Secret
Clearance Level Must Be Able to Obtain:
Top Secret/SCI
Public Trust/Other Required:
None
Job Family:
Healthcare Services
Job Qualifications:
Skills:
Care Planning, Company Policies, Medical Information, Regulatory Requirements, Treatment Plans
Certifications:
None
Experience:
2 + years of related experience
US Citizenship Required:
Yes
Job Description:
Seize your opportunity to make a personal impact as Nurse Case Manager supporting mission critical work on an exciting program. GDIT is your place to make meaningful contributions to challenging projects, build your skills, and grow a rewarding career.
At GDIT, people are our differentiator. As a Nurse Case Manager supporting our customer, you will help ensure today is safe and tomorrow is smarter. Our work depends on a Nurse Case Manager joining our team.
The Nurse Case Manager provides a full range of professional health nursing principles, practices, and procedures in clinical settings to analyze the full scope of problems associated with providing appropriate, cost-effective care to beneficiaries.
HOW A NURSE CASE MANAGER WILL MAKE AN IMPACT:
Collect, organize, record, and communicate data relevant to primary health assessments including a detailed medical history to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations.
Assess patients via the telephone, using established protocols, to provide appropriate and cost-effective care.
Establish priorities for patient care monitor and evaluate progress toward the stated goals to provide coordinated, efficient, effective health care to its beneficiaries.
Oversee discharge-planning activities to ensure ideal timing and sequencing of patient care.
Provide professional assistance to health care finders to identify patient's needs for referrals to appropriate health care providers or facilities.
Negotiate, write, finalize, and administer product/service agreements to ensure mutual compliance in meeting care goals.
Ability to design and present computer-generated outcome analysis information to provide timely, effective peer and higher-level educational programs or project briefings.
WHAT YOU'LL NEED TO SUCCEED:
2 years nursing experience and must be certified as a case manager by a recognized certifying organization, i.e. Commission for Case Management Certification or American Nurse Credentialing Center.
Current RN license; full, active, and unrestricted license as a Registered Nurse in one of any U.S. State, the District of Columbia, Guam, Puerto Rico or U.S. Virgin Islands.
Must maintain current certification in Basic Cardiac Life Support (BCLS) by the American Heart Association; must provide front and back proof of all training/certs/documentation.
Knowledge and skill in using pre-established utilizationreview criteria recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
Knowledge and skills in the use of VA/DOW Clinical Practice Guidelines to ensure an evidence based standardized process of care to military beneficiaries.
May be required to receive and maintain clinical practice privileges.
Maintain credentialing requirements in good standing at a local MTF.
Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
Skill in use of research tools to critically evaluate existing practices, opportunities, and outcomes.
Skill in management of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to involved stakeholders.
Knowledge of computers and software applications to conduct data collection, tracking, rending, and analysis.
Knowledge of pharmaceuticals, their desired effects, side effects, and complications of their use to gauge their effect on patients and their recovery.
Demonstrated knowledge of patient education principles and management of complex medical, psychosocial, and financial problems to enhance patient adherence to individualized treatment plans and train peers and staff.
Ability to seek feedback from peers, professional colleagues, clients, and outcomes research, to expand clinical knowledge, enhance role performance, and increase knowledge of professional issues.
Skills to effectively consult with health care providers at all levels and negotiate with outside providers for services and products to obtain client services and support.
Skill in team coordination, facilitation, and communication to facilitate the exchange of information/ education, enhance goal achievement; augment abilities of client support network, and effect change in system or policy at any level.
Knowledge of local, state, and federal laws and regulations, professional code of ethics, and practice standards to ensure adherence within legal and professional parameters.
U.S. Citizenship required.
Fluent oral and written communication skills in English to meaningfully interact with peers, outside agencies, vendors, providers, and Military Health System (MHS) stakeholders to exchange information, provide briefings, presentations, research, and metrics to demonstrate or advance effective, efficient case management practice, outcomes, and organizational/MHS values.
CLEARANCE: Ability to obtain and maintain Secret or Top-Secret Clearance.
LOCATION: Various CONUS SITES
This is a contingent posting, expected to start in 2026.
GDIT IS YOUR PLACE:
401K with company match
Comprehensive health and wellness packages
Internal mobility team dedicated to helping you own your career
Professional growth opportunities including paid education and certifications
Cutting-edge technology you can learn from
Rest and recharge with paid vacation and holidays
#MilitaryHealthGDITJobs
The likely salary range for this position is $83,927 - $113,549. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.
Scheduled Weekly Hours:
40
Travel Required:
Less than 10%
Telecommuting Options:
Onsite
Work Location:
USA FL Hurlburt Field
Additional Work Locations:
USA CO Fort Carson, USA NC Fort Bragg - Fort Bragg (NCC004), USA WA Joint Base Lewis-McChord
Total Rewards at GDIT:
Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee's date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.Join our Talent Community to stay up to date on our career opportunities and events at
gdit.com/tc.
Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans
Formulary Strategy & UtilizationReview Pharmacist
Shape the drug benefit landscape-analyze and optimize medication use.
Key Responsibilities:
Review prescribing trends and propose cost-saving alternatives.
Maintain evidence-based formularies across multiple payers.
Conduct retrospective DUR and prepare stakeholder reports.
Qualifications:
PharmD with managed care, DUR, or pharmacy benefit experience.
Strong Excel/data analytics background preferred.
Understanding of clinical guidelines and P&T processes.
Why Join Us?
Join a top-tier managed care team
Hybrid flexibility
Strategic and data-driven focus
$54k-64k yearly est. 60d+ ago
Nurse Consultant I (Family, Infant, and Preschool Program (FIPP))
Nc State Highway Patrol
Utilization review nurse job in North Carolina
Agency
Dept of Health and Human Services
Division
J. Iverson Riddle Developmental Center
Job Classification Title
Nurse Consultant I (NS)
Number
Grade
MH16
About Us
The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.
Description of Work
The Nurse Consultant I participates as a member of an interdisciplinary team of professionals providing early intervention and family support to children age birth through eight with or at risk for disabilities and their families. The nurse consultant has specific responsibility for providing nursing-related assessments and evaluations for children, instructing parents and caregivers in nursing-related activities to attain desired outcomes, and providing consultation and technical assistance to other staff and community paraprofessionals, professionals, and agencies. The Nurse Consultant I is expected to learn and use cross-disciplinary evidence-based early intervention practices, including caregiver coaching, family-centered practices, resource-based practices, and natural learning environment practices. The Nurse Consultant I is also responsible for maintaining contact with referral sources and identifying and developing relationships with potential referral sources to increase referrals. The Nurse Consultant I participates in activities to support FIPP's mission of providing a broad range of family-centered resources and supports to children and families by participating in research, publications, program evaluation, training, and other activities related to children's healthy development and/or parents' and caregivers' abilities to support their children's growth and development in the context of family wellbeing.
Knowledge Skills and Abilities/Management Preferences
Salary Range: $59,732.00 - $98,557.00
Recruitment Range: $59,732.00 - $98,557.00
A Sign-on bonus of $10,000 may be offered to the successful applicant(s) of this posting, contingent on the 2025-2026 Budget Approval.
Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.
The Knowledge, Skills, and Abilities (KSAs
)/
Management Preferences are not required. Applicants who possess the following skills are preferred:
Documented knowledge of basic nursing principles and techniques, with specialized knowledge of health and/or development of children age birth through eight.
Knowledge of Health and wellness issues for families, family systems theories, and family centered practices.
Knowledge of community systems, and provide patient and family information on services provided by FIPP and other organizations.
Knowledge about community resources or the skills to be able to locate and seek out resources for children and families, experience/training evaluating children and families, experience/training in developing community resources, experience/training in research, training and model development.
Skilled in child assessments, communicating with families at all levels of understanding, actively listening, assisting families in identifying strengths, goals, resources and individualized plans of action.
This Position Is Exempt And Is EXEMPT From Certain Provisions Of The State Human Resources Act (GS 126).
Shift Hours: 1st shift (8:00am-5:00pm), Monday - Friday, with occasional evening hours
About the Family, Infant and Preschool Program (FIPP):
The Family, Infant and Preschool Program (FIPP) is a community-based component of the J. Iverson Riddle Developmental Center. FIPP is an early childhood intervention and family support program that has been producing research and providing supports and services in western North Carolina since 1972. The overall mission of the program is to (1) promote optimal health and development of young children, especially those with or at risk for disabilities, through supporting and strengthening families in ways that enhance their growth and well-being; and (2) promote the dissemination of research, resources and professional development opportunities to improve the delivery of services to families and children.About J. Iverson Riddle Developmental Center:
The J. Iverson Riddle Developmental Center in Morganton, North Carolina is an ICF certified facility for individuals with intellectual disabilities. We provide comprehensive residential care to citizens from 37 counties in the western portion of the state. JIRDC is a caring community where professionals work with people of various ages, cognitive, & functional abilities.
The J. Iverson Riddle Developmental Center is located just an hour from the
Queen City of Charlotte,
home of the Carolina Panthers and the
City of Asheville,
home to the world renowned Biltmore Estate and Grove Park Inn. Our facility sits on one of the most picturesque properties in Burke County. We are nestled at the foot of the Blue Ridge and South Mountains and just minutes from beautiful Lake James. Nearby Pisgah National Forest offers outdoor adventure and fun for the whole family.Supplemental Contact Information:
The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer who embraces an Employment First philosophy which consists of complying with all federal laws, state laws and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about DHHS: ************************
Positions in the Division of State Operated Healthcare Facilities shall be subject to pre-employment drug testing and criminal record background checks. Also, the use of tobacco products of any kind including vapor products are prohibited from our campuses. All employees are required to adhere to the facility's Vaccination Policy.
DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.
In accordance with the Governor's Executive Order 303, our agency supports second-chance employment for individuals who were previously incarcerated, or justice involved. We invite all potential applicants to apply for positions for which they may be qualified.
Application Process
Be sure to complete the application in its entirety.
Resumes will not be accepted in lieu of completing this application.
Information should be provided in the appropriate areas, to include the following: Education, including high school and all degrees obtained, Work Experience, and Certificates & Licenses. It is critical to our screening and salary determination process that applications contain comprehensive candidate information.
Answers to Supplemental Questions are not a substitute for providing all relevant information within the body of your application. To receive credit for the supplemental questions, you must provide supporting information within the "Work Experience" section of the application, to support your answers.
If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted.
Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. Upon the closing date, applications are "Under Review" and will be screened by Human Resources for the qualified applicants. The hiring process may take several weeks.
Degrees must be received from appropriately accredited institutions. Transcripts and degree evaluations may be uploaded with your application. The State of North Carolina/Office of State Human Resources uses the National Association of Credential Evaluation Services (NACES) as a referral resource for applicants who need to have their credentials certified as equivalent.
For a list of organizations that perform this specialized service, please visit the NACES membership website at ******************************
Degree/College Credit Verification
Degrees must be received from appropriately accredited institutions.
Transcripts, degree evaluations and cover letters may be uploaded with your application.
Veteran's and National Guard Preference
Applicants seeking Veteran's Preference must attach a DD-214 Member-4 Form (Certificate of Release or Discharge from Active Duty) to their applications.
Applicants seeking National Guard Preference must attach an NGB 23A (RPAS), along with the state application if they are a current member of the NC National Guard in good standing.
Applicants who are former member of either the NC Army National Guard or the NC Air National Guard, with honorable discharge and six years of creditable service, must attach a copy of the DD 256 or NGB 22, along with the state application.
ADA Accommodations
Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA), DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment, DHHS will ensure that people with disabilities, or known limitations covered by the PWFA, are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process, please contact the person indicated below.
Eligibility for Sign-on Bonus:
To qualify for the Sign-on Bonus,
a
newly hired permanent full-time or permanent part-time employee must work 30 to 40 hours per week to be eligible. Those who are eligible and working less than 40 hours a week will receive a prorated rate.
An employee is not eligible for a sign-on bonus if:
The employee has held a position in the North Carolina State government, including the judicial system, or the University of North Carolina system, within the last 12 months (the employee shall remain ineligible for 12 months from the separation date)
The employee has previously received a sign-on bonus from any State agency
DHHS has paid any contract placement or recruitment fees.
All Sign-on Bonuses are contingent upon budget and final eligibility determination as of the effective date of hire. Additional information regarding the Sign-on Policy can be found here.
CONTACT INFORMATION:
If there are any questions about this posting, please contact Talent Acquisition at *****************************.
Resumes will not be accepted in lieu of completing this application.
Minimum Education and Experience
Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See the Education and Experience Equivalency Guide for details.
Licensed to practice as a Registered Nurse in the State of North Carolina and one year of experience in the area of specialization.
EEO Statement
The State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.
Recruiter:
Meganna Benner
Recruiter Email:
*************************
$59.7k-98.6k yearly Auto-Apply 60d+ ago
Senior Utility Coordinator
Stvinc
Utilization review nurse job in Raleigh, NC
STV is looking for a Senior Utility Coordinator for the Carolinas Utility Coordination group, based out of our Raleigh or Charlotte, North Carolina, offices. This position requires utility coordination experience for roadway and bridge replacement projects. STV is growing in the utility industry and needs a self-motivated, energetic employee who wants to join this high paced environment. STV is seeking a seasoned coordinator to provide support for QA/QC packages, monitor/drive project progress, and mentor junior staff.
Requirements:
It is preferred that the experience is with NCDOT and/or a similar agency.
This position would prefer someone who has extensive knowledge with whole process of utility coordination from design to construction.
It entails meeting/managing multiple utilities throughout the state of North Carolina, identifying potential utility conflicts due to roadway/bridge improvements, resolving those conflicts, commenting on schedule, and summarizing these findings to the client.
Utility coordination is more than identifying direct conflicts; It requires knowledge of construction methods for both the utilities as well as the infrastructure contractor.
This person will be responsible as the leading utility coordinator on multiple projects statewide.
This position will be responsible for training, mentoring, and monitoring junior level coordinators.
This person will assist the regional head of utility coordination with project staffing, budgets, schedules, business development, and/or client interactions.
He/She will need to be self-motivated, willing to travel (10%), and can manage schedule and budgets.
Qualifications:
Years of Experience - a minimum of 20 years of civil engineering or utility coordination experience.
Education - 2 yr associate's degree + 15 years of utility coordination experience
Experience - MicroStation/Geopak/Inroads and/or Civil 3D/AutoCAD preferred. This position requires competency in NCDOT plan reading.
Compensation Range:
$68,554.21 - $91,405.62
Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At STV, we are fully committed to expanding our culture of diversity and inclusion, one that will reflect the clients we serve and the communities we work in, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description we encourage you to apply anyways. You may be just the right candidate for this or other roles.
STV offers the following benefits • Health insurance, including an option with a Health Savings Account • Dental insurance • Vision insurance • Flexible Spending Accounts (Healthcare, Dependent Care and Transit and Parking where applicable) • Disability insurance • Life Insurance and Accidental Death & Dismemberment • 401(k) Plan • Retirement Counseling • Employee Assistance Program • Paid Time Off (16 days) • Paid Holidays (8 days) • Back-Up Dependent Care (up to 10 days per year) • Parental Leave (up to 80 hours) • Continuing Education Program • Professional Licensure and Society Memberships
STV is committed to paying all of its employees in a fair, equitable, and transparent manner. The listed pay range is STV's good-faith salary estimate for this position. Please note that the final salary offered for this position may be outside of this published range based on many factors, including but not limited to geography, education, experience, and/or certifications.
$68.6k-91.4k yearly Auto-Apply 34d ago
Utility Coordinator - Atlanta
Accura Engineering & Consulting Services 3.7
Utilization review nurse job in Charlotte, NC
Job Title: Utility Coordinator ***Work Location: Metro Atlanta (GDOT District 7) *** Salary: Based on experience and will be discussed with manager in interview
Duties/Responsibilities
:
Serve as a liaison between designers, utility agencies, and project owners.
Conduct and document utility coordination meetings, including meeting minutes and follow-up actions.
Maintain records of all utility coordination activities.
Communicate status updates to project teams regarding utility coordination.
Manage pre-construction utility coordination for moderate to complex Georgia Department of Transportation (GDOT) projects, including Concept, Preliminary Design, and Final Design phases.
Administer utility coordination for Design-Build projects, Local Government Projects, and roadway contractors.
Develop and process utility agreements, contract item agreements, and lighting agreements.
Execute memorandums of understanding and conduct prior rights research.
Assist with the administration of GDOT's electronic permitting program (GPASS/GUPS).
Develop and provide training for GDOT Districts and State Utilities Offices.
Perform analyses for complex engineering and environmental projects.
Demonstrate competency in field supervision, technical knowledge, and project management.
Interpret findings accurately and identify inconsistencies or inappropriate results.
Provide mentorship and training to subordinate staff.
Assume full responsibility for managing large tasks or projects, including strategy development, budgeting, and project deliverables.
Manage and communicate results, budgets, and schedules to clients, project managers, and operations teams.
Ensure compliance with company administrative, financial, and safety policies.
Education/Experience:
High School Diploma required, bachelor's degree preferred but not required
Minimum of 7 years of transportation experience in construction inspection, design, and/or utility coordination.
Strong problem-solving skills and ability to manage tasks and projects efficiently.
Demonstrated experience in client relations, decision-making, and leadership.
Excellent written and verbal communication skills.
Ability to build and maintain effective internal and external relationships.
Willingness to develop business from new and existing clients.
Ability to work in an office environment with occasional field site visits for progress reviews and quality control.
Benefits:
Competitive salary based on experience.
Comprehensive health, dental, and vision insurance.
Retirement savings plan with company match.
Paid time off and holidays.
Professional development and career advancement opportunities.
A supportive and collaborative work environment.
Equal Opportunity Employer (U.S.) all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity, or any other characteristic protected by law. Accura uses E-Verify in its hiring practices to achieve a lawful workplace. *******************
$43k-55k yearly est. 60d ago
Nurse Case Manager II
Elevance Health
Utilization review nurse job in Durham, NC
**Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
**_Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law._**
**Work Schedule:** Monday to Friday from 11:30 AM to 8:00 PM EST.
**_***This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria._**
The **Nurse Case Manager II** is responsible for care management within the scope of licensures for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Perform duties telephonically or on-site such as at hospitals for discharge planning.
**How you will make an impact:**
+ Ensures member access to services appropriate to their health needs.
+ Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
+ Implement care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
+ Coordinates internal and external resources to meet identified needs.
+ Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
+ Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
+ Negotiate rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues.
+ Assists with development of utilization/care management policies and procedures.
**Minimum Requirements:**
+ Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
+ Current unrestricted RN license in applicable state(s) required.
+ Multi-state licensure is required if this individual provides services in multiple states.
**Preferred Experience, Skills, and Capabilities:**
+ Case Management experience preferred.
+ Certification as a Case Manager preferred.
+ Managed Care experience preferred.
+ Ability to talk and type at the same time preferred.
+ Demonstrate critical thinking skills when interacting with members preferred.
+ Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly preferred.
+ Ability to manage, review and respond to emails/instant messages in a timely fashion preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $76,944 to $120,912.
Locations: Colorado; Illinois; Nevada
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$76.9k-120.9k yearly 56d ago
Admissions Nurse
PACS
Utilization review nurse job in North Carolina
Now Hiring: Admissions Nurse (RN or LPN) South Creek Post Acute Schedule: Monday-Friday, 11:00 AM - 7:00 PM South Creek Post Acute is seeking a dedicated Admissions Nurse to join our team. This position plays a key role in coordinating patient admissions and ensuring a smooth transition into our facility.
Position Details:
* Schedule: Monday-Friday, 11:00 AM - 7:00 PM
* License: RN preferred; LPN will be considered
* Pay Range: $40-$55 per hour, based on credential and experience
Key Responsibilities:
* Coordinate and complete patient admissions
* Review and verify admission documentation
* Communicate with hospitals, families, and interdisciplinary team members
* Ensure compliance with facility policies and regulatory requirements
* Provide a positive admission experience for new residents
Qualifications:
* Active RN or LPN license in good standing
* Strong communication and organizational skills
* Experience in post-acute, skilled nursing, or admissions preferred
* Ability to work independently and collaboratively
Why Join South Creek Post Acute:
* Competitive wages
* Consistent weekday schedule
* Supportive team environment
* Meaningful role in patient care transitions
Equal Employment Opportunity Statement:
South Creek Post Acute is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other protected status in accordance with applicable laws.
$40-55 hourly Auto-Apply 28d ago
RN Hospital Nurse Liaison
Authoracare Collective
Utilization review nurse job in Greensboro, NC
Our Mission: AuthoraCare Collective empowers people to be active participants in their care journey, enabling them to live on their own terms through personalized support for mind, body, and spirit. Our patients are always the author of their life story. During a challenging illness, AuthoraCare Collective helps them author more moments that matter, regardless of the stage of their illness or condition. This is captured by our tagline: Your Story. Our Expert Care.
Finally, the job you have been looking for!
AuthoraCare Collective is currently seeking an RN Hospital Nurse Liaison Float. This is a full-time (40 hours per week) position with week-end responsibility/rotation supporting our Forsyth, Davie, High-Point and Winston-Salem service areas.
Job Summary:
Evaluate the clinical needs of newly referred and hospitalized hospice patients. Identify and inform patient and family about appropriate resources. Work with the patient/caregiver and appropriate providers to establish patient/caregiver care goals and identify and implement interventions.
With attending physician and selected members of the IDT, ensure that a medical plan of care is established and implemented for the patient. Communicate effectively with other members of the interdisciplinary team and health care providers, as needed.
Community and Hospital Staff Relations:
* Collaborates with hospital staff and Palliative Medicine Team to ensure effective and efficient working operations for referrals and current hospice patients.
* Consistently models respect for, and accountability to, the public, patients/families, and co-workers.
* Communication and actions reflect care, courtesy, honesty, and professionalism.
* Facilitate positive relationships with hospital staff, physicians, and community.
* Meet deadlines and respond to requests in a timely and professional manner.
* Meet agency regulatory/licensure requirements that affect job responsibilities.
* Maintains effective relationships and partnerships with community healthcare providers.
* Attends agency and departmental meetings.
* Ensures professional growth and development, incorporates changes/ advances in nursing practice into own practice.
* Volunteers for projects and accepts assignments for projects as follows through.
Our team members enjoy Work/Life Balance and the following benefits: Paid time off (PTO), Seven paid holidays, flexible work schedules, medical, dental, vision, disability, and life insurance. Employee engagement activities and 403B match after 12 months of service.
Education/Experience:
* Must be currently licensed as an RN in North Carolina with a minimum of 3-5 years of experience in an acute or home health setting.
* Bachelor's degree in nursing and Hospice experience preferred. RN Certification in
Hospice and Palliative Care preferred.
* Understand and be committed to the Hospice and Palliative philosophy of care.
Other: Valid state-issued driver's license required. Must carry automobile liability insurance at limits required by agency. Must have own transportation.
$50k-66k yearly est. 22d ago
Pediatric Field Nurse - Atrium Health Hospital at Home (8a-8p) FT
Advocate Health and Hospitals Corporation 4.6
Utilization review nurse job in Charlotte, NC
Department:
34124 Carolinas Medical Center - Pediatric: Hospital at Home
Status:
Full time
Benefits Eligible:
Yes
Hours Per Week:
36
Schedule Details/Additional Information:
8a - 8p/ 3 days per week / every 3rd to 4th weekend
Pay Range
$38.20 - $57.30
Major Responsibilities
Uses the nursing process to assess the needs of the patient, plan and implement individualized interventions in the home and evaluate the effectiveness of the plan of care. Includes the patient and family in planning and implementing care and develops and maintains a therapeutic relationship throughout the healthcare continuum.
Anticipates and recognizes significant changes in the patient's condition, status, and need for care escalation that may be need in the in-home care setting. Provides in home assessment of the patient and takes appropriate actions when changes occur. Anticipates and alters the plan of care as needed, mobilizes appropriate resources, and collaborates with other health care team members to coordinate patient centered care. Implements trategies to reduce patient risk and increase patient safety while in the home.
Actively coordinates the discharge plan utilizing an interdisciplinary approach. Applies evidence-based practice to deliver patient care in the home. Consistently incorporates nursing and regulatory standards of care into practice.
Provides ongoing in-home evaluation of patient, team, and unit outcomes and is empowered to take appropriate action when changes are needed while providing care in the home. Supports shared governance activities and initiatives to improve processes and patient outcomes.
Demonstrates effective communication and promotes collaboration among healthcare team members virtually and in-person. Assumes a leadership role in the care team and delegates appropriately to unlicensed personnel.
Promotes a culture of safety through identifying threats to patient and in-home care team's safety and intervening to prevent harm. Reports patient safety events and near misses in a timely manner. Seeks to identify potential safety issues and assists in the implementation of corrective actions.
Applies ethical decision making, demonstrates respect and understanding for peers, and other clinical disciplines. Participates as an effective member of the patient care team while working in the home to formulate an integrated, unbiased, individualized approach to care.
Participates in quality/process improvement initiatives to improve the functions of the department and the in-home patient care experience.
Participates in professional activities which contribute to personal professional development and the development of others. Seeks opportunities to be taught, coached, and mentored. Attends required meetings/educational programs and completes annual competencies in a timely manner.
Must be able to demonstrate knowledge and skills necessary to provide in-home care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards.
Minimum Job Requirements
)
Education
Completion of an accredited or approved program in Nursing.
Certification / Registration / License
Registered Nurse license issued by the state in which the team member practices
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA).
Required to have a valid driver's license issued by the Division of Motor Vehicles and acceptable vehicle operator record
Travel required within designated geographic area
Pediatric Advanced Life Support (PALS) issued by the American Heart Association (AHA) preferred
Work Experience
Minimum of two-years of recent nursing experience in an acute bedside setting or emergency nursing
Pediatric experience strongly preferred within the last 3 years
Knowledge / Skills / Abilities
Demonstrates progression to provide holistic patient care in the home and the ability to view clinical situations from a patient and family focus.
Demonstrates progression to recognize situational changes while providing care in the home that requires unplanned or unanticipated interventions, and responds to situations with confidence, timeliness and flexibility.
Proficiency in phlebotomy skills, IV insertion, and Midlines .
Proficient technology skills, use of electronic mail, electronic medical records systems, and remote patient monitoring equipment
Excellent communication (written and verbal), listening and interpersonal skills.
Ability to work independently while in the patient's home in collaboration with the virtual care team.
Provides comprehensive nursing assessment in an untraditional nursing environment.
Demonstrates human relation skills with the ability to develop rapport and maintain positive, professional relationships with a variety of patients, team members and physicians while providing care in the home. Ability to take initiative and work collaboratively with others.
Demonstrated ability to effectively make critical, independent decisions.
Excellent organization, prioritization and problem-solving skills.
Demonstrates time management skills with an ability to multi-task and prioritize in an environment with frequent interruptions.
Demonstrates coordination, collaboration, delegation and team building skills.
Physical Requirements and Working Conditions
Must be able to sit, stand, walk, lift, squat, bend, reach above shoulders, and twist frequently throughout the workday in possible confined spaces.
Must be able to work safely with people of various sizes and weight with diverse and complex medical conditions and physical limitations.
Must be able to:
lift up to 50 lbs. from floor to waist.
lift up to 20 lbs. over the head.
carry up to 40 lbs. a reasonable distance.
Must be able to:
push/pull with 30 lbs. of force.
May be exposed to chemical and hazardous waste as well as blood and body fluids and communicable disease. Therefore, protective clothing and equipment must be worn as necessary.
Must have functional speech, vision, hearing, and touch with ability to use fine hand manipulation skills for IV insertion and other procedures/functions.
Operates all equipment necessary to perform the job.
Work environment includes probability of exposure to adverse, hazardous, or unpleasant conditions while caring for the sick
Must be able to travel to all areas within the Advocate service area in all extremes of weather on all types of roads
Must have a tolerance for differences and an appreciation of multi-culturalism and diversity of the patients and their families.
Required to make visits to private residences which may not be accessible to people with disabilities.
DISCLAIMER
All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.
This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Compensation
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Benefits and more
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
$38.2-57.3 hourly Auto-Apply 60d+ ago
Nurse Consultant I (Educator)) - Cherry Hospital
Health & Human Services 4.2
Utilization review nurse job in Waynesville, NC
Agency
Dept of Health and Human Services
Division
Cherry Hospital
Job Classification Title
Nurse Consultant I (S)
Number
60045951
Grade
MH16
About Us
The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.
Description of Work
This position is responsible for the development, coordination, and teaching of the Nursing Departmental orientation program and for performing unit-based orientation. This position serves as the Nurse Educator/Preceptor for all new RN's and LPNs. The position also performs competency checkoffs for Professional Nurses, Licensed Practical Nurses, and Health Care Technicians. The position serves as a resource for increasing performance in staff requiring assistance in reaching their potential within their job role.
Work schedule is primarily 8:00am to 5:00pm when assigned to Educator/Preceptor duties. Works rotating shifts, weekends and holidays as needed to provide training and complete Educator/Preceptor duties.
Knowledge Skills and Abilities/Management Preferences
Recruitment Range: $80,000 - $95,224
*A Sign-on bonus of $10,000 may be offered to the successful applicant(s) of this posting, contingent on the 2025-2026 Budget Approval.
Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.
The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:
*Analytical and problem-solving are essential
*Knowledge and skill in group theory/dynamics, nursing process and practice
*Working knowledge of adult learning principles, teaching techniques, and public speaking
*Ability to effectively teach nursing staff and other employees as appropriate through orientation and on-the- go job training
Anticipated Vacancy
This position is Exempt from all provisions of NC General Statute Chapter 126 with the exception of Articles 6 and 7. State Human Resources Act (GS 126)
This Position Is Designated as Mandatory And
Must
Report Or Stay Over During Adverse Weather Events.
*Eligibility for Sign-on Bonus
To qualify for the Sign-on Bonus,
a
newly hired permanent full-time or permanent part-time employee must work 30 to 40 hours per week to be eligible. Those who are eligible and working less than 40 hours a week will receive a prorated rate.
An employee is not eligible for a sign-on bonus if:
The employee has held a position in the North Carolina State government, including the judicial system, or the University of North Carolina system, within the last 12 months (the employee shall remain ineligible for 12 months from the separation date)
The employee has previously received a sign-on bonus from any State agency
DHHS has paid any contract placement or recruitment fees.
All Sign-on Bonuses are contingent upon budget and final eligibility determination as of the effective date of hire. Additional information regarding the Sign-on Policy can be found here.
About the Facility:
Cherry Hospital is a State-of-the-Art Psychiatric hospital located in Goldsboro, North Carolina. Cherry Hospital serves the 38 most eastern counties of North Carolina with a mission to serve those with the greatest need and the fewest resources. We strive to create a healing environment in which every team member has opportunity to positively impact the lives of those around them and the individuals we serve. Learn more about our facility at ************************************************************************************************************* In addition to a very competitive salary, this opportunity offers an excellent benefits package, loan repayment opportunities, employment stability and rewarding professional opportunities.
Supplemental Contact Information:
DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.
Positions in the Division of State Operated Healthcare Facilities shall be subject to pre- employment drug testing and criminal record background checks. Also, the use of tobacco products of any kind including vapor products are prohibited from our campuses. All employees are required to adhere to the facility's Vaccination Policy.
Application
Process
Be sure to complete the application in its entirety.
Resumes will not be accepted in lieu of completing this application.
Information should be provided in the appropriate areas, to include the following: Education, including high school and all degrees obtained, Work Experience, and Certificates & Licenses. It is critical to our screening and salary determination process that applications contain comprehensive candidate information.
Answers to Supplemental Questions are not a substitute for providing all relevant information within the body of your application. To receive credit for the supplemental questions, you must provide supporting information within the "Work Experience" section of the application, to support your answers.
If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted. Applications must be submitted by 11:59pm prior to the closing date.
Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. Upon the closing date, applications are "Under Review" and will be screened by Human Resources for the qualified applicants. The hiring process may take several weeks.
Degrees must be received from appropriately accredited institutions. Transcripts and degree evaluations may be uploaded with your application. The State of North Carolina/Office of State Human Resources uses the National Association of
Credential Evaluation Services (NACES) as a referral resource for applicants who need to have their credentials certified as equivalent. For a list of organizations that perform this specialized service, please visit the NACES membership website at ******************************
Veteran's and
National
Guard
Preference
Applicants seeking Veteran's Preference must attach a DD-214 Member-4 Form (Certificate of Release or Discharge from Active Duty) to their applications.
Applicants seeking National Guard Preference must attach an NGB 23A (RPAS), along with the state application if they are a current member of the NC National Guard in good standing.
Applicants who are former member of either the NC Army National Guard or the NC Air National Guard, with honorable discharge and six years of creditable service, must attach a copy of the DD 256 or NGB 22, along with the state application.
ADA Accommodations
Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA), DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment, DHHS will ensure that people with disabilities, or known limitations covered by the PWFA, are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process, please contact the person indicated below.
Applicants will be communicated via email only for updates on the status of their application. If there are any questions about this posting other than your application status, please contact HR at *************.
Minimum Education and Experience
Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See the Education and Experience Equivalency Guide for details.
Licensed to practice as a Registered Nurse in the State of North Carolina and one year of experience in the area of Registered Nurse.
EEO Statement
The State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.
Recruiter:
Angela Darden Gurley
Email:
*****************************
$80k-95.2k yearly Auto-Apply 5d ago
Reserve Nurse
Dev 4.2
Utilization review nurse job in North Carolina
Jobs for Humanity is dedicated to building an inclusive and just employment ecosystem. Therefore, we have dedicated this job posting to individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Ethnic Minority, and the Previously Incarcerated. If you identify with any of the following communities do not hesitate to register, even if you feel that this particular opportunity is not the right fit for you.
Company Name: Colten Care
Job Description
Reserve Nurse
Salary: N/A
Part Time
Want to travel the world and make a difference? The Army Reserve is the perfect place to start - whether you're fully trained or have already started a degree in Nursing. You'll help keep the Army running, whether that's by helping soldiers in the field, at an NHS trust or from a Medical Regiment in the UK. Wherever the British Army is, you'll find our Nurses giving first rate nursing care in all sorts of environments and situations.
Reach new heights. Make a difference.
As you travel the world, gaining valuable skills and civilian recognised qualifications along the way, you'll learn how to work in the most challenging environments with minimal equipment. This is your chance to achieve greatness and learn vital skills that'll set you up for life. This is your chance to do something that matters.
You'll be paid on a daily rate commensurate to your qualifications. This includes being paid for weekly drill nights. Plus, if you complete all of your annual training days, you're entitled to a tax-free lump sum called a bounty.
JOIN AS A REGISTERED NURSE
You'll command a team that provides the highest standard of care. Army nursing can be tough, so we'll give you the best possible military and professional training. You can develop your skills throughout your career with further study up to and beyond MSc level, funded by us. It's not all hard work though. You'll also get to travel, take part in Adventure Training and play sports for the Army. With a competitive salary, non-contributory pension and free healthcare too, you'll get great rewards - and an amazing experience.
Opportunities to commission as an Officer depend upon your knowledge, skills and experience. During your Army Nursing application, we will advise and support you in making the right career choice for you so that you can realise your true potential.
JOIN AS A STUDENT NURSE
You can join the Army Reserve as a Student Nurse, however, until you complete your Nurse training and are registered with the Nursing and Midwifery Council (NMC) you will fulfil an alternative role within the medical unit of your choice.
To become an Army Reserve Nurse you'll:
- Need to be registered with the National Medical Council.
- Be clinically qualified, current and working in this field
For more information on entry requirements Search Army Nurse.
Our next deadline for application is
31st March 2023
, with further opportunities ongoing throughout the year. This is your chance to experience full-time soldier opportunities in a role that fits around your life. Are you ready for an adventure?
Find where you belong.
$41k-56k yearly est. 1d ago
Field Nurse Practitioner - Gaston County, North Carolina
Advantmed 3.6
Utilization review nurse job in Gastonia, NC
Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations.
The building B.L.O.C.K.S. of our team's success!
Bring the fun
Leverage together for better
Outperform yourself
Care at every touchpoint
Keep your word. Keep it real
Stay curious & listen well
Primary Purpose:
We are proud of the quality care we provide members and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at risk populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities.
Learn more about our primary purpose here
Follow us on LinkedIn:
******************************************
NP Responsibilities:
Perform annual in-home wellness visits and risk adjustment health assessments on a population with chronic conditions; Our thorough evaluations include: a comprehensive assessment, physical examination, body system review, vital signs, review of medication history, review of current prescriptions, review of member functional status, pain management, cognitive assessment, review of the home environment, fall risk screening, social assessment, review of daily living activities, mental health screening, documentation and communication
You will play a pivotal role in providing individualized quality care to the elderly population in their homes
Deliver patient health education on topics such as pain management, medication, etc.
Build relationships of trust with members through exceptional communication and empathy
Assist in closing quality care gaps (i.e. screenings and labs)
An enthusiastic collaborator contributing to the enhancement of care delivery
Providers are expected to commit a minimum of 30 hours per month
Locations:
Gaston County, NC
Requirements
NP Qualifications:
Must have a valid unencumbered NP License for the state you will be working in
This role requires travel within the assigned job posting county up to a maximum 55-mile radius
Previous in-home risk assessment experience preferred
Previous 1099 (PRN) experience is preferred but not required
3 years patient care experience preferred (primary care/adult/geriatric, EMR)
May be requested to obtain additional NP licensure supported by Advantmed
Access to reliable transportation that will enable you to travel to member's homes within a designated area
Strong ability to work within our EMR system
Ability to work independently
Bilingual is a plus
Benefits
Advantmed offers:
Competitive wages (contractor per diem, per completed in-home assessment rate ~$100)
Paid mileage
Flexible work schedule
Evening and weekend availability
No on-call
Visits ready to be scheduled immediately
Appointment confirmation support
Dedicated coordinator support
Advanced member scheduling coverage
State of art technology
$68k-103k yearly est. Auto-Apply 60d+ ago
Nursing - 33930001
Greensboro 4.1
Utilization review nurse job in Greensboro, NC
Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details.
Ventura MedStaff benefits represent the care and compassion we provide for our clients.
• Health, dental, vision, life, disability benefits and 401k
• Tax free stipends when applicable
• Gym discounts
• Weekly pay
• $750.00 referral bonus
Please apply or contract us at: *********************** or ************