• Utilization Management

    CVS Health (Raleigh, NC)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (07/31/25)
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  • Utilization Management Nurse…

    CVS Health (Raleigh, NC)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects… more
    CVS Health (07/23/25)
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  • Utilization Management Nurse…

    CVS Health (Raleigh, NC)
    …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... Qualifications** + Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or Nursing Diploma… more
    CVS Health (08/01/25)
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  • Utilization Management Nurse…

    CVS Health (Raleigh, NC)
    …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in ET zones **Education**… more
    CVS Health (08/01/25)
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  • Pharmacy Network Management

    Prime Therapeutics (Raleigh, NC)
    …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Management Consultant - Remote **Job Description** The Network Management ... Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply… more
    Prime Therapeutics (07/15/25)
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  • Sr. Consultant , Territory…

    Cardinal Health (Raleigh, NC)
    **_What Specialty Networks contributes to Cardinal Health_** Specialty Networks creates clinical & economic value for independent specialty providers & partners in ... Networks in creating value to the members in their clinical , operational, and economical goals. This individual will be...Member Profiles and overall success of membership network with utilization and optimization of Salesforce keeping up to date… more
    Cardinal Health (07/25/25)
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  • Workfront Configuration Consultant

    Eliassen Group (Raleigh, NC)
    … to support the implementation of Workfront as an Enterprise Portfolio and Project Management tool. As the Senior Consultant , you will work closely with our ... **Workfront Configuration Consultant ** **Anywhere** **Type:** Contract **Category:** Development **Industry:** Insurance **Workplace Type:** Remote **Reference ID:**… more
    Eliassen Group (07/01/25)
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  • Cfsp - I/DD and TBI Clinical Director

    Elevance Health (Durham, NC)
    …Health Care Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives; assists in ... term services and supports, Unmet health-related resource needs, and Integrated care management . We envision a North Carolina where all children and families are… more
    Elevance Health (07/15/25)
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  • Medical Director - Commercial

    Elevance Health (Winston Salem, NC)
    …work East Coast time zone hours.** The **Medical Director** will be responsible for utilization review case management for Commercial business in the New England ... programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
    Elevance Health (07/25/25)
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  • Physician (Chief of Imaging Service)

    Veterans Affairs, Veterans Health Administration (Salisbury, NC)
    …as the Chief of the Imaging Service. The Chief has full responsibility for clinical practice, program management , education, human resource management and ... Serves as the liaison to other services and facilities by advising of specific clinical or administrative issues Serves as a consultant , mentor, and advisor to… more
    Veterans Affairs, Veterans Health Administration (07/29/25)
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