• Social Worker- Case Management

    UNC Health Care (Rocky Mount, NC)
    …related to one CQI program. 9. Performs other duties as assigned. Assists with behavioral health housing placements. Provides observation for behavioral ... Utilization . Develop and maintain care plans for active management of patients who frequently seek ED care-Track high...**Job Details** Legal Employer: Nash Hospitals Entity: Nash UNC Health Care Organization Unit: NGH Case Management … more
    UNC Health Care (08/26/25)
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  • RN Care Manager Case Management

    UNC Health Care (Eden, NC)
    …of patients based on various factors such as medical conditions, social determinants of health , and behavioral health needs. b. Develop strategies to ... 7. Payer Communication: a. Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and facilitate timely… more
    UNC Health Care (09/26/25)
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  • Clinical Care Advisor - Transition of Care Healthy…

    Elevance Health (NC)
    …licensure. Manages overall healthcare costs for the designated population via integrated (physical health / behavioral health ) case management and whole ... have access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy, Intellectual/Developmental Disabilities (I/DD)… more
    Elevance Health (09/19/25)
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  • CFSP Director Substance Use Disorder Programs…

    Elevance Health (Fayetteville, NC)
    …have access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy, Intellectual/Developmental Disabilities (I/DD) ... markets. + Build alliances across the business including Care Management , Utilization Management , Network, Clinical,...direct reports. **Minimum Qualifications:** + Requires MS in a behavioral health field (ie social work, counseling)… more
    Elevance Health (09/05/25)
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  • CFSP Managed Care Coordinator- Region 4

    Elevance Health (Durham, NC)
    … under the CFSP Care Management model, including coordination across physical health , behavioral health , I/DD, LTSS, pharmacy, and unmet health ... access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy,_ _Intellectual/Developmental_ _Disabilities (I/DD)… more
    Elevance Health (09/30/25)
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  • Medical Director

    Elevance Health (NC)
    …law._ The **Medical Director** is responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... an equivalent background. * _For Health Solutions and Carelon organizations (including behavioral health ) only, a minimum of 5 years of experience providing … more
    Elevance Health (09/29/25)
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  • Transitions of Care - RN, 100% Virtual, CareBridge

    Elevance Health (NC)
    …patients, patients with IDD and patients with special needs is preferred. + Home Health , Utilization Management or Case Management experience strongly ... care plans by educating members regarding clinical needs and facilitating referrals to health professionals for behavioral health needs. + Uses motivational… more
    Elevance Health (10/01/25)
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  • RN Care Manager - UNC Disposition Resource Team

    UNC Health Care (Chapel Hill, NC)
    …of patients based on various factors such as medical conditions, social determinants of health , and behavioral health needs. b. Develop strategies to ... 7. Payer Communication: a. Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and facilitate timely… more
    UNC Health Care (09/06/25)
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  • Manager Payor Contracting

    Novant Health (Charlotte, NC)
    …acts as a liaison between the department, revenue cycle services teams, finance, utilization management , and clinical leaders related to managed care contracting ... Job Summary The purview of Novant Health 's Revenue & Relationship Management team...Contract Negotiations + Specialty Contracting (transplant networks, commercial plan behavioral health ) + Government contracting including Managed… more
    Novant Health (08/13/25)
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  • LTSS Service Coordinator-RN Clinician

    Elevance Health (Charlotte, NC)
    …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and accurate… more
    Elevance Health (08/28/25)
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