- 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
- 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
- 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