• Stabilization Services Manager

    City of Durham (Durham, NC)
    …service delivery documentation (including counseling/treatment planning), HIPAA/Confidentiality standards, utilization review , and data management. Strong ... Stabilization Services Manager Print (https://www.governmentjobs.com/careers/durhamnc/jobs/newprint/5013877) Apply  Stabilization Services Manager Salary… more
    City of Durham (07/22/25)
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  • Manager I Care Management Team (DSS Region…

    Elevance Health (Wilkesboro, NC)
    …**LOCATION** **: This is a field role and w** **e are seeking a manager who will be comfortable traveling within the county.** **HOURS** **: Standard business hours, ... an accommodation is granted as required by law. The Manager Care Management, Foster Care ( Manager I...include, but are not limited to: + Manages resource utilization to ensure appropriate delivery of care to members,… more
    Elevance Health (07/18/25)
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  • TRC Manager

    Eaton Corporation (Arden, NC)
    …North American Sales division is currently seeking a Technical Resource Center (TRC) Manager to join their team. This hybrid position will be located in Arden, ... NAS and product marketing with business information and drive utilization of this information by the businesses. * Manage...of new team members. * Work with the TRC manager and others in the development and deployment of… more
    Eaton Corporation (07/30/25)
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  • District Sales Manager - Usbl - US

    Sysco (Concord, NC)
    **JOB SUMMARY** The District Sales Manager (DSM) role requires exceptional management of sale performance among Sales Consultants (SCs). This position is responsible ... developing the talent of their sales consultants to achieve profitable planned case and GP growth **RESPONSIBILITIES** + Manages the performance and development of… more
    Sysco (07/18/25)
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  • Medical Director, MSK Surgery

    Evolent (Raleigh, NC)
    …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical...and findings with matrixed Physician Business Manager . + Provides medical direction to… more
    Evolent (05/20/25)
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  • Medical Director - Commercial

    Elevance Health (Winston Salem, NC)
    …to work East Coast time zone hours.** The **Medical Director** will be responsible for utilization review case management for Commercial business in the New ... and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers...state or territory of the United States when conducting utilization review or an appeals consideration and… more
    Elevance Health (07/25/25)
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  • Infusion Referral Nurse- REMOTE

    Prime Therapeutics (Raleigh, NC)
    …clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + At minimum must ... for drug services. + Will actively maintain a required case load and the activities to reach overall goals...Quality oversight for this program is provided by the Manager , Patient Programs. **Education & Experience** + Associates -… more
    Prime Therapeutics (07/24/25)
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  • Clinical Liaison Rehab Services

    UNC Health Care (Rocky Mount, NC)
    …reviews for private insurance companies, Medicare and Medicaid, in accordance with utilization review guidelines. 2. Reviews assigned patients' cases prior to, ... for pathways, protocols, or guidelines that could improve patient care and utilization of resources. Effectively collaborates with and mobilizes resources and team… more
    UNC Health Care (07/24/25)
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  • Medical Director Associate - Carelon RX

    Elevance Health (Durham, 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 ... ensuring clinical integrity of broad and significant clinical programs. May perform clinical review . **How you will make an impact:** + May provide clinical guidance… more
    Elevance Health (07/04/25)
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  • Health & Group Benefits Consulting Senior…

    Deloitte (Raleigh, NC)
    …as general health and group benefits skills. Key Responsibilities + Lead project manager for specific projects or key workstream lead on larger projects. + Evaluate ... Pharmacy Benefit Manager (PBM) contracts, deal terms, and financial proposals. +...vendor selection, negotiation, and implementation. + Assist in the review and negotiation of premium rate/administrative fee renewals. +… more
    Deloitte (07/31/25)
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