- Elevance Health (Durham, NC)
- ** Utilization Management Medical Director - NC Medicaid** Location: This role enables associates to work virtually full-time, with the exception of ... Alternate locations may be considered. The ** Medical Director ** will be responsible for utilization review case management for North Carolina Medicaid.… more
- UNC Health Care (Morrisville, NC)
- …and well-being of the unique communities we serve. **Summary** : The **Executive System Director of Utilization Management (UM)** is a strategic and ... Executive Director works closely with leaders from various departments-case management , physician advisors, revenue cycle, medical staff, nursing, and… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests ... required turnaround times. * Prepares and presents cases to Medical Director (MD) for medical ...Utilization Review process including benefit interpretation, contract language, medical and policy review. * Proficient in MCG and… more
- Elevance Health (Durham, NC)
- …responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for both ... Director ** is responsible for serving as the Operational Medical Director for our care management...director provides clinical expertise in all aspects of utilization review and case management . Provides input… more
- Elevance Health (Durham, NC)
- ** Medical Director Associate - CarelonRx** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... dispensing services to drive affordability and improve member outcomes. The ** Medical Director Associate- CarelonRx** supports pharmacy prior authorization… more
- CREO (Durham, NC)
- JOB DESCRIPTION OVERVIEW The Director , Technology Strategy and Solutions, is a high visibility client-facing leader responsible for a book of business and products ... is approximately 50% business development and 50% services, technical and management consulting project delivery and team leadership. Within CREO's seller-doer… more
- Fujifilm (Holly Springs, NC)
- **Position Overview** As the Senior Director , Process Engineering & Maintenance, this role is responsible for setting the direction and managing central workstreams ... leveraging existing experience as a subject matter expert (SME) and people management capabilities in start-up of Greenfield capital projects and technical projects.… more
- Kyndryl (Research Triangle Park, NC)
- …looking for a dynamic individual like you, who can revolutionize relationship management , drive account growth, and boost profitability. In this role, you'll have ... closely with other sales team members to ensure a seamless account management process. Together, you'll execute every aspect flawlessly, from the initial prospecting… more
- UNC Health Care (Chapel Hill, NC)
- …**Professional Experience Requirements:** * Five (5) years of experience in care management , utilization management , discharge planning, care coordination, ... operations for designated Clinical Care Management Department team(s). Provides management direction to Case Managers, Utilization Managers, Clinical Social… more
- CenterWell (Lillington, NC)
- …caring community and help us put health first** Reports To: Associate Director , Home Health Branch Administrator FLSA: Exempt **Work Schedule** : Full-time/40 Hours ... of care and outcome planning. + Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. +… more
- Fresenius Medical Center (Garner, NC)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more