- Elevance Health (Charlotte, NC)
- …Coordinator - RN Clinician** is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN ... clinicians participating in the member's case in accordance with applicable state law and contract;...the member's needs, with the goal of optimizing member health care across the care continuum. **How you will… more
- Elevance Health (Morganton, NC)
- …child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), and regardless ... access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy, Intellectual/Developmental Disabilities (I/DD) services,… more
- CRC Insurance Services, Inc. (Charlotte, NC)
- …the business requirements. 10. Assist/coordinate pre-planning activities (eg business case , project estimate, project risk assessment, stakeholder analysis, draft ... 14. Observe and ensure strict adherence to all Technology and Truist Insurance Holdings policies and standards (eg Systems Development Life Cycle (SDLC), Change… more
- Elevance Health (Winston Salem, NC)
- …be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May be responsible for developing and ... with providers and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss… more
- Elevance Health (NC)
- …patients with IDD and patients with special needs is preferred. + Home Health , Utilization Management or Case Management experience strongly preferred. + ... delivery of patient education and disease management interventions and for performing health coaching for members, across multiple lines, for health … more
- CenterWell (Rocky Mount, NC)
- …provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused ... **Become a part of our caring community and help us put health first** Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide… more
- Elevance Health (Morganton, NC)
- …child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), and regardless ... access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy, Intellectual/Developmental Disabilities (I/DD) services,… more
- Elevance Health (NC)
- …and/or medical policies. May collaborate with healthcare providers. Focuses on relatively complex case types that do not require the training or skill of a ... physicians, healthcare service providers and internal and external customers to help improve health outcomes for members. + Refers to complex or unclear reviews to… more
- Elevance Health (NC)
- …appropriate areas to refer to or assign cases (utilization management, case management, QI, Med Review). + Provides information regarding network providers ... skills, facilitation skills, and analytical skills._ Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed… more
- Veterans Affairs, Veterans Health Administration (Fayetteville, NC)
- …vesting) and federal 401K with up to 5% in contributions by VA Insurance : Federal health /vision/dental/term life/long-term care (many federal insurance ... All qualified applicants will be referred to the hiring manager on a weekly basis. The Deputy Chief of...strategies such as clinical practice guidelines and critical pathways, health risk assessments, provider profiling, use of electronic medical… more