• Prior Authorization UM…

    Humana (Raleigh, NC)
    …a part of our caring community and help us put health first** The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ... and most appropriate treatment, care or services for members. UM Administration Coordinator 2 + Support the...or more years of experience with Utilization Review and/or Prior Authorization + 1 or more years… more
    Humana (07/31/25)
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  • Telephonic UM Administration…

    Humana (Raleigh, NC)
    …part of our caring community and help us put health first** The Telephonic - UM Administration Coordinator / UM Administration Coordinator 2 provides ... most appropriate treatment, care or services for members. Telephonic UM Coordinator/ UM Administration Coordinator...+ Member service + Experience with Utilization Review and/or Prior Authorization , preferably within a managed care… more
    Humana (07/30/25)
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  • Director Utilization Management

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …clinical background within a managed care setting including a high-level understanding of prior authorization process from beginning of ingestion at Intake level ... About The Role The Director, Utilization Management ( UM ) will manage the Utilization Management team consisting of Clinicians and Non-Clinical support staff from… more
    Brighton Health Plan Solutions, LLC (07/18/25)
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  • Sr Analyst, Scope Management

    Evolent (Raleigh, NC)
    …Association (AMA), Centers for Medicare & Medicaid Services (CMS), Food and Drug Administration (FDA), and various prior authorization lists, facilitating ... and informatics professionals who work with national health plans to ensure that prior authorization and financial coding stay accurate, compliant, and aligned… more
    Evolent (07/18/25)
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