• Foster Care Adoption Manager (Region 7)

    Elevance Health (Raleigh, NC)
    ** Managed Care Coordinator ** **Sign-on Bonus: $2500** **We are currently seeking people in the following counties and look forward to speaking with you!** ... welfare system so that they receive seamless, integrated, and coordinated health care . Within the Children and Families Specialty Plan (CFSP), and regardless of… more
    Elevance Health (06/29/25)
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  • Utilization Management Administration…

    Humana (Raleigh, NC)
    …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Clerical support background in a healthcare ... caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration … more
    Humana (08/08/25)
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  • Remote Korean Bilingual Member Engagement…

    BeneLynk (Charlotte, NC)
    …improve lives and positively impact Social Determinants of Health barriers by providing our Managed Care partners with the information they need, and people with ... service of this one central vision. REMOTE MEMBER ENGAGEMENT COORDINATOR (Korean speaking) POSITION SUMMARY We are actively seeking...making and fielding calls to help Medicare and Medicaid Managed Care Plan Members determine which benefit(s)… more
    BeneLynk (08/07/25)
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  • Pharmacy Coordinator Senior

    Highmark Health (Raleigh, NC)
    …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... and efficient delivery of pharmacy call center services. The Pharmacy Coordinator is responsible for supporting Highmark Wholecare's pharmacy programs with a… more
    Highmark Health (07/22/25)
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  • Hospice Clinical Coordinator

    Novant Health (Charlotte, NC)
    …criteria for determining patient eligibility for admission. Ability to interpret insurance agreements/ managed care contracts to provide appropriate care to ... variety of patients. Ability to effectively negotiate contract/non-contracted rates for appropriate managed care depending on fair market analysis of current… more
    Novant Health (08/08/25)
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  • Project Administrative Coordinator

    Stantec (Charlotte, NC)
    When you care deeply about the work you do, it's rewarding to see it through from concept to completion. We partner with clients to provide both program management ... transit systems, water treatment facilities, mines, and wind farms, we've successfully managed thousands of projects. Joining our team, turning visionary ideas into… more
    Stantec (08/07/25)
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  • Care Manager

    AmeriHealth Caritas (Cullowhee, NC)
    …meeting goals and resolving problems + Coordinates care and services with the Care Coordinator , Community Health Navigator, and member, member care giver ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
    AmeriHealth Caritas (07/29/25)
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  • Care Manager

    AmeriHealth Caritas (Greenville, NC)
    …goals and resolving problems. + Coordinates care and services with the Care Coordinator , Community Health Navigator, and member, member care giver ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
    AmeriHealth Caritas (07/27/25)
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  • Pediatric Care Manager

    AmeriHealth Caritas (Greenville, NC)
    …meeting goals and resolving problems + Coordinates care and services with the Care Coordinator , Community Health Navigator, and member, member care giver ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
    AmeriHealth Caritas (07/27/25)
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  • SIU Specialist - Pharmacy Tech - Remote in…

    Prime Therapeutics (Raleigh, NC)
    …Examiner credential preferred. + Bachelor's degree preferred. + Prefer knowledge of managed health care business model and processes, preferably in behavioral ... recommendations. + MISCELLANEOUS DUTIES: + Provide backup support to team members (SIU Coordinator and Senior SIU Specialist) in the performance of job duties as… more
    Prime Therapeutics (06/24/25)
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