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SalaryJoin Our Community Choices Team as a Utilization Review Nurse Manager!
Are you passionate about ensuring patients receive the highest quality care while managing healthcare costs effectively? We're looking for a dynamic individual to join our North Carolina Administration team in the role of Utilization Review Nurse Manager!
As a Utilization Review Nurse Manager, you'll play a vital role in our NC programs by meticulously assessing patient care plans and medical records to ensure the necessity and effectiveness of treatments. You'll collaborate with healthcare providers, insurance companies, and managed care organizations to balance patient needs with cost-effective healthcare solutions.
What You'll Do:
- Review patient charts to ensure medical necessity and appropriate level of care.
- Manage authorization processes to track service statuses across multiple programs.
- Collaborate with various stakeholders to ensure effective communication and coordination.
- Educate staff on efficient care practices and cost-effective treatment plans.
- Provide decision support and conduct negotiations for service approvals.
- Maintain accurate records and ensure compliance with healthcare regulations.
Qualifications:
- Graduate of an accredited School of Nursing.
- Minimum 1 year of utilization management experience.
- Current, valid, and unrestricted NC state RN license.
- Bachelor of Science in Nursing required; certification in healthcare quality and management desirable.
- Excellent organizational, leadership, and communication skills.
Position Details: Utilization Review Nurse Manager
Exempt Level
Salary Range: $65,000 - $95,000 annually based on experience
Submit the following documents with application:
- A detailed resume- Transcripts- NC R.N. license number - Three (3) references
Why Join Us?
- Make a difference in optimizing patient outcomes and reducing unnecessary medical expenses.
- Collaborative work environment with opportunities for professional growth.
- Competitive compensation and benefits package.
- Join a team dedicated to providing quality healthcare services to our community.
Apply Today!
If you're ready to take the next step in your nursing career and make a positive impact on patient care, we want to hear from you! Join us in our mission to provide cost-effective healthcare solutions while ensuring the highest standards of patient care.
Don't miss out on this exciting opportunity – apply now and be part of the Community Choices team!
We are an equal opportunity employer and value diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
Job Type: Full-time
Pay: $65,000.00 - $95,000.00 per year
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Application Question(s):
- Please list you RN license number?
- What types of patients have you primarily worked with in your nursing career?
Education:
- Bachelor's (Required)
Experience:
- Utilization management: 1 year (Required)
License/Certification:
- Driver's License (Required)
Ability to Commute:
- Charlotte, NC 28227 (Required)
Ability to Relocate:
- Charlotte, NC 28227: Relocate before starting work (Required)
Work Location: Hybrid remote in Charlotte, NC 28227
