- Healthfirst (NC)
- … management, identifying alternative care options, and discharge planning** + **Certified Case Manager ** + **Interqual and//or Milliman knowledge** + **Knowledge ... This position is 100% Remote** **Duties//Responsibilities:** + **Provides case management services for assigned member caseloads which includes:** +… more
- ERP International (Cherry Point, NC)
- **Overview** ERP International is seeking full-time **Registered Nurse (RN) Case Manager ** in support of theNaval Health Clinic Cherry Point, NC. Apply online ... for community resources. * Integrate CM and utilization management ( UM ) and integrating nursing case management with...Possess one of the following certifications:** **o** Commission for Case Manager Certification Certified Case … more
- UNC Health Care (Raleigh, NC)
- **Description** **Our Case Management team is seeking a System-wide Complex Case Manager to provide support to a network of 6 owned and 10 managed ... teams, and will report to the Regional Director of Case Management.** Become part of an inclusive organization with...CAPP as appropriate. As necessary meet with the Utilization Manager ( UM ) and SW after the meeting… more
- UNC Health Care (Raleigh, NC)
- …(EDD). Complete follow-up from CAPP as appropriate. As necessary meet with the Utilization Manager ( UM ) and SW after the meeting to discuss updates and action ... continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and discharge planning. The Care Manager … more
- Elevance Health (Durham, NC)
- **Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual Preferred** **Sign On Bonus:** $3,500 **Location - Virtual:** This role enables associates to ... part of a rotating schedule._ The **Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual Preferred**...healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to… more
- Brighton Health Plan Solutions, LLC (NC)
- About The Role The Manager , Utilization Management ( UM ) will manage the Utilization Management team consisting of Clinicians and Non-Clinical support staff. The ... accuracy and alignment with regulatory requirements. + Facilitate training for UM team members including Nurses and Coordinators on systems, departmental processes,… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role BHPS provides Utilization Management ( UM ) services to its clients, ensuring high-quality, clinically sound decision-making. The Clinical Appeal and ... quality-focused, production-driven environment. The position reports directly to the Clinical Appeal Manager . Note: This job description is not intended to be an… more
- UNC Health Care (Rocky Mount, NC)
- …wellbeing. Summary: Provides general clerical, secretarial and organizational support to the Manager of Care Management, to the departmental staff, and to the ... Workers (SW), and Point of Entry Utilization Managers (POE UM ) *Discuss referred cases, including, patient status, barriers to...Hospitals Entity: Nash UNC Health Care Organization Unit: NGH Case Management Work Type: Full Time Standard Hours Per… 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