- 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 ... completing the business process documents, Business use cases, Business case scenarios, user acceptance test case scenarios,...Utilization Review (DUR) and pharmacy lock-in related processes o Behavioral health , and A+ kids. o Preferred… more
- Elevance Health (Durham, NC)
- ** Behavioral Health Case Manager I - North Carolina** A proud member of the Elevance Health family of companies, **Carelon Behavioral Health ... Friday, 8:00 am (EST) to 5:00 pm (EST)** The ** Behavioral Case Manager I** is...visits within the scope of licensure for members with behavioral health and substance abuse or substance… more
- Elevance Health (Durham, NC)
- ** Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual Preferred** **Location - Virtual:** This role enables associates to work virtually ... on holidays as part of a rotating schedule._ The ** Behavioral Health Care Manager I...substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member… more
- Highmark Health (Raleigh, NC)
- …ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs ... interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are...various resources to assist members in achieving their personal health goals. The incumbent monitors, improves and maintains quality… more
- Humana (Raleigh, NC)
- …part of our caring community and help us put health first** The Telephonic Nurse Case Manager will be a member of the In-Home Case Management Team, ... case management throughout the continuum of care. The case manager will offer guidance, support, and...the beneficiary for all activities within the medical and behavioral health spectrum. They will also coordinate… more
- CVS Health (Raleigh, NC)
- …members. **Key Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or ... previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health /Substance Abuse or Maternity/ Obstetrics experience.… more
- Maxim Healthcare (Raleigh, NC)
- Maxim Healthcare in Raleigh is hiring for a Case Manager to oversee the clinical care of homecare clients Why This Role? + Balanced Responsibilities + Work-Life ... team where your expertise and dedication are truly valued. Maxim Benefits: Health and Wellness Medical/Prescription, Dental, Vision, Health Advocacy (company… more
- Elevance Health (Cary, NC)
- …licensure. Manages overall healthcare costs for the designated population via integrated (physical health / behavioral health ) case management and whole ... access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy,_ _Intellectual/Developmental_ _Disabilities (I/DD)… more
- Elevance Health (Pittsboro, NC)
- …access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy,_ _Intellectual/Developmental_ _Disabilities (I/DD) ... an accommodation is granted as required by law._ The Manager Care Management, Foster Care ( Manager I...to the CFSP Care Management model which includes physical health , behavioral health , and social… more
- City of Durham (Durham, NC)
- …meet the needs of people in crisis with compassionate care and behavioral health expertise. Interested applicants can visit our website ... Familiarity with Durham health systems and community resources/services for physical health behavioral and mental health , substance use, Intellectual… more
- UNC Health Care (Chapel Hill, NC)
- …of patients based on various factors such as medical conditions, social determinants of health , and behavioral health needs. b. Develop strategies to ... high-quality, coordinated care. **What You'll Do** As a Care Manager RN, you'll: + Provide ongoing support and clinical...discharge planning. + Serve as a key resource in case management, utilization review, and discharge planning. + Stay… more
- Highmark Health (Raleigh, NC)
- …appropriate resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality ... and refer members whose healthcare outcomes might be enhanced by Health Coaching/ case management interventions. + Employ collaborative interventions which… more
- University of North Carolina- Chapel Hill (Chapel Hill, NC)
- …Experience working within an interdisciplinary team and/or training/leading behavioral health professionals ( PSS , QP, case managers, paraprofessionals, ... Position Summary/Description: UNC Horizons at Wake seeks a Program Manager to support the clinical and administrative for new...project staff and oversee the referral lines to initiate behavioral health services. This position will be… more
- City of Durham (Durham, NC)
- …meet the needs of people in crisis with compassionate care and behavioral health expertise. Interested applicants can visit our website ... Clinical Manager Print (https://www.governmentjobs.com/careers/durhamnc/jobs/newprint/5106349) Apply Clinical Manager Salary $91,308.00 - $146,109.00 Annually… more
- Zoom (Raleigh, NC)
- What you can expect We are looking for a Lifecycle Campaign Manager to drive lifecycle programs focused on engagement and monetization, driven by customer type and ... record of delivering measurable revenue impact through A/B testing, behavioral targeting, and personalized lifecycle journeys. + Demonstrate in...opportunity. Below is the potential closing date, just in case you want to mark it on your calendar.… more
- Elevance Health (Raleigh, NC)
- …program. Manages overall healthcare costs for the designated population via integrated (physical health / behavioral health ) case management and whole ... to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy,_ _Intellectual/Developmental_...required by law._ The Clinical Care Advisor (Special Programs Case Manager I) is responsible for providing… more
- Highmark Health (Raleigh, NC)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
- BrightSpring Health Services (Raleigh, NC)
- …to deliver integrated, whole-person care management addressing a member's physical health , behavioral health , intellectual/developmental disability (I/DD), ... the member/family/guardian to complete the Preliminary Questionnaire + Communicates with the Case Manager any information pertaining to the care and well-being… more
- Elevance Health (Durham, NC)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... vision and implementation to deliver an improvement in the health of the people we serve. The medical director...clinical expertise in all aspects of utilization review and case management. Provides input on the clinical relevance to… more
- Highmark Health (Raleigh, NC)
- …+ Healthcare experience + Project Management experience **Preferred** + 2 years Health Plan, Pharmacy Benefit Manager (PBM) or Pharmaceutical manufacturer ... to understand business needs, processes project specifications and business case development. Translate business needs into clearly defined and...environment + Experience in a Health Plan or PBM pharmacy department supporting strategic care… more
