- COOLSOFT (Raleigh, NC)
- …and Prior Authorizations, Drug Utilization Review (DUR) and pharmacy lock-in related processes, Behavioral health , and A+ kids, Preferred Drug List (PDL) and ... Utilization Review (DUR) and pharmacy lock-in related processes o Behavioral health , and A+ kids. o Preferred...solutions. - Preferred to have experience with Medicaid, managed care , and Pharmacy Benefit Manager (PBM) operations.… more
- Elevance Health (Durham, NC)
- ** Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual Preferred** **Location - Virtual:** This role enables associates to work ... members are required to work on holidays as part of a rotating schedule._ The ** Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual… more
- Elevance Health (Durham, NC)
- ** Behavioral Health Case Manager ...depression, and insightful analytics to improve the delivery of care . Candidates** **Must live in the state of North ... the Elevance Health family of companies, **Carelon Behavioral Health ** , offers superior clinical mental...Friday, 8:00 am (EST) to 5:00 pm (EST)** The ** Behavioral Case Manager I** is responsible for… more
- Elevance Health (Durham, NC)
- …and Experiences** : + Managed care or healthcare experience preferred. + Behavioral health marketing experience preferred. Please be advised that Elevance ... **Marketing Manager ** **Location:** This role requires associates to be...developing omni-channel marketing plans and working collaboratively with our behavioral health business unit and across the… more
- UNC Health Care (Smithfield, NC)
- …psychiatric evaluation, medication management, and stabilization. The Behavioral Health Triage process ensures patients receive immediate care through ... utilizing the nursing process in a hospital setting. ** BEHAVIORAL HEALTH DEPARTMENT** UNC Health ...aware of public policy and regulatory guidelines affecting the health care environment. Promotes a safe, clean… more
- UNC Health Care (Chapel Hill, NC)
- … Health Emergency Department (BHED)! UNC Hospitals Behavioral Health Emergency Department (BHED) provides care to approximately 5,000 patients annually. ... accommodate up to 42 beds for patients seeking mental health care in a patient centered environment....with professional standards. Reporting and accountable to the Nurse Manager /Director, the Clinical Nurse is responsible for coordinating and… more
- UNC Health Care (Chapel Hill, NC)
- …satisfaction by promoting high-quality, coordinated care . **What You'll Do** As a Care Manager RN, you'll: + Provide ongoing support and clinical expertise ... well-being of the unique communities we serve. Summary: The Care Manager RN plays a crucial role...various factors such as medical conditions, social determinants of health , and behavioral health needs.… more
- UNC Health Care (Garner, NC)
- …the health and well-being of the unique communities we serve. Summary: The Care Manager RN plays a crucial role in providing comprehensive and coordinated ... care transitions, delegated work, and payer communication. The Care Manager works collaboratively with healthcare providers,...various factors such as medical conditions, social determinants of health , and behavioral health needs.… more
- Elevance Health (Cary, NC)
- …health services. + Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. + Travels to ... \#HealthyBlueCareTogetherCFSP **IDD Specialty Care Manager Lead** **$3,500 SIGN ON...of integrated (physical and behavioral ) whole person care . + Coordinates social determinants of health … more
- Elevance Health (Pittsboro, NC)
- …ensuring fidelity to the CFSP Care Management model which includes physical health , behavioral health , and social services. Primary duties may include, ... an accommodation is granted as required by law._ The Manager Care Management, Foster Care ...Service delivery coordination, discharge planning or behavioral health experience in a managed care setting… more
- Highmark Health (Raleigh, NC)
- …implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. + Function in… more
- UNC Health Care (Smithfield, NC)
- …psychiatric evaluation, medication management, and stabilization. The Behavioral Health Triage process ensures patients receive immediate care through ... utilizing the nursing process in a hospital setting. ** BEHAVIORAL HEALTH DEPARTMENT** UNC Health ...aware of public policy and regulatory guidelines affecting the health care environment. Promotes a safe, clean… more
- Elevance Health (Cary, NC)
- …for the Children and Families Specialty Plan integrated physical health and behavioral health care management teams and the development, implementation ... is strongly preferred. + Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. + Travels to… more
- Elevance Health (Raleigh, NC)
- …highly preferred. + Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred. + Experience ... accommodation is granted as required by law._ The Clinical Care Advisor (Special Programs Case Manager I)...of integrated (physical and behavioral ) whole person care . + Evaluates social determinants of health … more
- CVS Health (Raleigh, NC)
- …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health /Substance Abuse or Maternity/ Obstetrics experience.… more
- Maxim Healthcare (Raleigh, NC)
- …offer private duty nursing, skilled nursing, physical rehabilitation, companion care , respite care and behavioral care for individuals with chronic and ... Maxim Healthcare in Raleigh is hiring for a Case Manager to oversee the clinical care of...your expertise and dedication are truly valued. Maxim Benefits: Health and Wellness Medical/Prescription, Dental, Vision, Health … more
- Highmark Health (Raleigh, NC)
- …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs… more
- City of Durham (Durham, NC)
- …Assistance Response Teams)-to meet the needs of people in crisis with compassionate care and behavioral health expertise. Interested applicants can visit ... Navigation, Familiar Neighbors, and the Office of Survivor Care . Each program includes its own program manager... health systems and community resources/services for physical health behavioral and mental health ,… more
- Humana (Raleigh, NC)
- …(SDOH). Plan shall include psychosocial issues, home environment and behavioral health needs across the full continuum of care . Maintain beneficiary's ... the beneficiary for all activities within the medical and behavioral health spectrum. They will also coordinate...disciplinary action. + An active designation as a Certified Care Manager (CCM). If no active designation… more
- BrightSpring Health Services (Raleigh, NC)
- …integrated, whole-person care management addressing a member's physical health , behavioral health , intellectual/developmental disability (I/DD), ... documentation of billable events that align with minimum contact expectations to the Care Manager + Maintains an accurate, up-to-date electronic information data… more
