- UNC Health Care (Raleigh, NC)
- …efficiency, and effectiveness. The Utilization Manager works collaboratively with other Clinical Care Management staff to ensure patient needs are met and ... and treatments. Communicates daily with the Case Manager to manage level of care transitions...issues, continuing care needs by initiating appropriate case management referrals. Initiates appropriate social work… more
- BrightSpring Health Services (Raleigh, NC)
- Our Company StepStone Family & Youth Services Responsibilities The Foster Care Case Manager works under the supervision of the Program Manager . They are ... responsible for the delivery of case management services, individual and family counseling and training and...and training and supervision of foster families. The Foster Care Case Manager assists the… more
- CVS Health (Raleigh, NC)
- …and deliver solutions to make health care more personal, convenient and affordable. This Case Manager RN position is 100% remote and the employee can live in ... purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our...or Multi state licensure - Certified Case Manager (CCM) - Telephonic case management… more
- CVS Health (Raleigh, NC)
- …This Case Manager RN position is part of Aetna's Commercial Care Management division and is part of the dedicated team supporting the membership ... more personal, convenient and affordable. Position Summary The Case Manager RN position is 100% remote...face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate… more
- BAYADA Home Health Care (Siler City, NC)
- …properly document doctors' orders + Perform client assessments as necessary + Case management and coordination + Accurately document observations, interventions, ... and evaluations pertaining to client care management and services provided, utilizing a state-of-the-art touch pad tablet **Qualifications for a Registered Nurse… more
- CVS Health (Raleigh, NC)
- …to make health care more personal, convenient and affordable. Position Summary The Case Manager RN position is 100% remote and employees can live in any ... to join our team, in the role of Telephonic Case Manager . RN Case Managers...Reviews prior claims to address potential impact on current case management and eligibility. - Assessments include… more
- Highmark Health (Raleigh, NC)
- …manage an active case load of members in his/her panel that are enrolled in case management . The incumbent conducts outreach to members enrolled in case ... to appropriate resources for additional support. + For assigned case load, create care plans to address...regulatory agency requirements and applicable standards of practice for case management including those published by CMSA… more
- Sedgwick (Raleigh, NC)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with ... Taking care of people is at the heart of...the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery… more
- LifePoint Health (Wilson, NC)
- …of Utilization Management , Case Management , and Discharge Planning. The Case Manager is responsible for care coordination and development of the ... *_Position Summary_*: An active member of the interdisciplinary healthcare team the Case Manager facilitates internal and external delivery of healthcare… more
- Elevance Health (Cary, NC)
- …specialty programs for autism and depression, and insightful analytics to improve the delivery of care . The BH Case Manager I is responsible for performing ... case management telephonically and/or by home visits within the scope...+ Conducts assessments to identify individual needs and develops care plan to address objectives and goals as identified… more
- Guardian Life (Raleigh, NC)
- Grow your career with Guardian in our newly created opportunity as a **Claim Case Manager II, Supplemental Health** ! In a culture where "People Count," "We Do ... if benefits are available under other product lines. + Utilize claim management resources, ie, spreadsheets for various blocks of business, and other processing… more
- Universal Health Services (Raleigh, NC)
- …https://uhs.alertline.com or ### . Qualifications POSITION SUMMARY: + To provide quality case management and qualified professional support and services to ... more than 90,000 employees and through its subsidiaries operates 26 acute care hospitals, 328 behavioral health facilities, 42 outpatient facilities and ambulatory … more
- Cardinal Health (Raleigh, NC)
- **_What Individualized Care contributes to Cardinal Health_** Delivering an exclusive model that fully integrates direct drug distribution to site-of- care with ... * Track any payer/plan issues and report any changes, updates, or trends to management * Search insurance options and explain various programs to the patient while… more
- UNC Health Care (Hillsborough, NC)
- …designated Clinical Care Management Department team(s). Provides management direction to Case Managers, Utilization Managers, Clinical Social Workers, ... we serve. Join our dynamic team as an on-site manager at our Hillsborough campus, where you'll lead a...organizational standards. Reports to the Assistant Director of Clinical Care Management . Responsibilities: 1. Assists Assistant Director… more
- UNC Health Care (Hillsborough, NC)
- …care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager must ... In addition, previous experience with Inpatient EPIC EHR and Case Management is preferred. The schedule expectations...tasks (eg, faxing, form processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager… more
- UNC Health Care (Morrisville, NC)
- …care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Care Manager must ... plan. Refer administrative tasks (eg, faxing, form processing) to Care Management Assistant. Consult Social Worker and/or Utilization Manager per established… more
- Humana (Raleigh, NC)
- …community and help us put health first** Humana Healthy Horizons in Virginia is seeking a Manager , Care Management (LTSS-ABD) who will lead a team of nurses ... compliance with contractual requirements and industry best practices. The Manager , Care Management (LTSS-ABD) works...Three (3) or more years of professional experience in Case Management , in Medicaid and/or Medicare, specifically… more
- UNC Health Care (Morrisville, NC)
- …populations. Consistently achieves established productivity targets. Responsibilities: 1. Provides care management services in the ambulatory practice setting. ... setting caring for patients with complex medical conditions required. Experience in case management , utilization review, quality management preferred.… more
- UNC Health Care (Smithfield, NC)
- …of care and cost effectiveness through the integrating and functions of case management , utilization review and discharge planning. The Inpatient Care ... - Review and prioritize consults received. Participate in Daily Care Management Touchpoint per established protocols. If...plan of care barriers to the appropriate Care Manager for discussion, as necessary meet… more
- UNC Health Care (Morrisville, NC)
- …communities we serve. Summary: Responsible for development and supervision of the Care Management Program, including hiring and training of qualified staff ... of Care / Case Managers, Registered Dietitians, Care ... management and supervision of centralized and embedded care management programs. Responsible for recruiting, training,… more