- CenterWell (Raleigh, NC)
- …short-term interventions, and connection to community-based resources. This role brings behavioral health expertise and addresses social determinants of ... of an interdisciplinary team-particularly in partnership with primary care teams, community health workers, pharmacists, and behavioral health specialists.… more
- Highmark Health (Raleigh, NC)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- Elevance Health (Winston Salem, NC)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... fee for service and assisting nurses as needed with review of claims. Works with other Medicare Administrative Contractor...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- Defense Health Agency (North Liberty, NC)
- …**This position is located at WOMACK Army Medical Center in the Department of Behavioral Health at the Womack Army Medical Center, Fort Bragg, NC.** This ... + Serve as expert advisor on Army, and MTF behavioral health policies and procedures to successfully...+ Participate in quality assurance, and quality improvement studies, utilization review , risk management, and peer … more
- City of Durham (Durham, NC)
- …meet the needs of people in crisis with compassionate care and behavioral health expertise. (Interested applicants can visit our website ... Service Definitions, ie ACT, CST IOP, SACOT, Innovation Wavier), utilization review , and data management. + Knowledge... health systems and community resources/services for physical health behavioral and mental health ,… more
- Highmark Health (Raleigh, NC)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This role is responsible for designing, developing, implementing, supporting, and optimizing ... stakeholder concerns. **Key Responsibilities:** + Lead and participate in Architecture Review Board processes, providing expert guidance on cloud-based solutions and… more
- UNC Health Care (Goldsboro, NC)
- …commitment incentive.** The Emergency Department is a 52-bed unit, including a 4-bed Behavioral Health Unit. It features three triage rooms, an ambulatory area ... **Description** This position qualifies for our UNC Health Wayne Incentive Program, which includes up to $35,000… more
- LifePoint Health (Hickory, NC)
- …execution, adaptation and outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, appropriateness of care and ... delivery network committed to/making communities healthier/(R)with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your… more
- Highmark Health (Raleigh, NC)
- **Company :** Highmark Health **Job Description :** Entirely Remote Work From Anywhere Role! We are seeking an experienced Software Engineering Manager to lead our ... have budgetary responsibility and authority. + Understand budget and resource utilization across the product teams. Escalate any issues regarding product delivery… more
- Highmark Health (Raleigh, NC)
- …Wholecare's pharmacy programs with a focus on medication adherence and optimizing member health outcomes. This role involves a high volume of daily contacts with ... address medication-related issues, promote adherence, and ensure appropriate medication utilization . **ESSENTIAL RESPONSIBILITIES** + Communicate effectively with physicians and… more