- Zurich NA (Raleigh, NC)
- AVP, Utilization Review & Pharmacy 123092 Zurich Insurance...a home -based office. As the AVP of Utilization Review & Pharmacy, you will lead and ... is seeking an AVP, Utilization Review & Pharmacy. This is a...is seeking an AVP, Utilization Review & Pharmacy. This is a fully remote position,...direct a team of Utilization Review and Pharmacy nurses who are… more
- CenterWell (Greensboro, NC)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... help us put health first** Reports To: Associate Director, Home Health Branch Administrator FLSA: Exempt **Work Schedule** :...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- HCA Healthcare (Asheville, NC)
- …this opportunity compelling, we encourage you to apply for our Registered Nurse Home Care Coordinator CarePatners opening. We promptly review all applications. ... recognized. Submit your application for the opportunity below:Registered Nurse Home Care Coordinator CarePatnersCarePartners **Benefits** CarePartners, offers a total… more
- HCA Healthcare (Asheville, NC)
- …provides satisfaction and personal growth, we encourage you to apply for our Home Care Clinical Coordinator opening. We promptly review all applications. Highly ... with purpose and integrity. We care like family! Jump-start your career as a Home Care Clinical Coordinator today with CarePartners. This position is eligible for a… more
- LifePoint Health (Rutherfordton, NC)
- …execution, adaptation and outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, appropriateness of care and ... and mentors all staff in UR standards and LOS topics. *Insures effective Utilization Review Process.*1. Performs admission and concurrent medical record … more
- CenterWell (Raleigh, NC)
- …programs and will be charged to appropriately balance how we mitigate utilization management administrative costs while maintaining or decreasing drug spend & trend, ... Guide (NFG). This individual influences the department's strategy for optimizing the utilization management process in balance with mitigating drug utilization … more
- Evolent (Raleigh, NC)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
- Evolent (Raleigh, NC)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... is a key member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical Directors and interacts with… more
- Evolent (Raleigh, NC)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... cases. you will be a key member of the utilization management team. We can offer you a meaningful...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- Evolent (Raleigh, NC)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Director you will be a key member of the utilization management team. We can offer you a meaningful...the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
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