- CVS Health (Raleigh, NC)
- …comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred . Leads a team in the planning and execution of investigations of ... best course of action to take in a timely and effective manner. Conducts case reviews and provides feedback to investigators on completeness and quality of the… more
- Chiesi (Cary, NC)
- …environmental standards, to ensure the wellbeing of our people, patients, and communities . We offer a work environment where professionals have the opportunity to ... utilization management criteria against contracting objectives and Develop account business case and analytics to support strategy + Support GtN forecasting… more
- RELX INC (Raleigh, NC)
- …using the best model from today's top model creators for each individual legal use case . About The Role We are seeking a dynamic and strategic GTM Strategy Lead to ... skills + Have knowledge about DAAS and API's (highly preferred ) Work in a way that works for you...employees are inspired to undertake initiatives that make unique contributions to society and the communities in which we… more
- Elevance Health (Greensboro, NC)
- …of Social Services through Foster Care and Adoptive Assistance programs is strongly preferred . + Certified Case Manager Certification strongly preferred ... of medical and behavioral health complexity and acuity. Manages overall healthcare costs, case management and whole person health. **How you will make an impact:** +… more
- Elevance Health (Jacksonville, NC)
- …with the most suitable foster families. The coordinator works closely with case managers, foster families, and other stakeholders to facilitate placements and ... provide ongoing support. **How you will make an impact:** + Perform case management telephonically and/or through home visits within the scope of licensure for… more
- Elevance Health (Durham, NC)
- …thinking skills and nursing judgment and experience + Collaborates with case management nurses on discharge planning, ensuring patient has appropriate equipment, ... Educates members about plan benefits and physicians and may assist with case management + Collaborates with leadership in enhancing training and orientation… more
- CenterWell (Hickory, NC)
- …As a **Home Health Registered Nurse** , you will: + Provide admission, case management, and follow-up skilled nursing visits for home health patients. + Administer ... on-going care and case management for each patient, provide necessary follow-up as...patient, provide necessary follow-up as directed by the Clinical Manager . + Confer with physician in developing the initial… more
- Elevance Health (Winston Salem, NC)
- …plan modifications and determines need for additional services, in conjunction with case management and provider. + Coordinates identification of and referral to ... on ways to reduce health risks. + Prepares reports to document case and compliance updates. + Establishes and maintains relationships with agencies identified… more
- CenterWell (Greensboro, NC)
- …for normality, fax a copy of lab to doctor, make a copy for the Case Manager , and route to Medical Records Department. Initiate Employee / Patient Infection ... calls from the field staff and assisting with weekly case conferences. Refers clinical questions to Branch Director as...health experience. + Prior packet review / QI experience preferred . + Coding certification is preferred . **Scheduled… more
- Travelers Insurance Company (Charlotte, NC)
- …with insured based on application of policy information to facts or allegations of each case . + Consults with Manager on use of Claim Coverage Counsel as needed. ... **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By...to 30% **What Will Our Ideal Candidate Have?** + Preferred Education, Work Experience and Knowledge + Bachelor's Degree… more