- UNC Health Care (Chapel Hill, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... case management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization management… more
- Elevance Health (Cary, NC)
- … with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, ... **Managed Care Coordinator Clinician Non RN ** **Location:** Remote, within 50 miles of an...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- Sharecare, Inc. (Raleigh, NC)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... with the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations… more
- Centene Corporation (Raleigh, NC)
- …flexibility. **Position Purpose:** Supervise and facilitate the daily operations of the case management and utilization management functions + Oversee the ... workflow and day-to-day operations of high risk case management and utilization management functions,...including provider issues, service gaps and member needs **Education/Experience:** RN license or Master's degree in Behavioral … more
- Universal Health Services (Raleigh, NC)
- …management experience preferred. Licensure/Certification: + Current North Carolina State Registered Nurse License + Current North Carolina Driver's License ... and through its subsidiaries operates 26 acute care hospitals, 328 behavioral health facilities, 42 outpatient facilities and ambulatory care access points,… more
- Elevance Health (Cary, NC)
- …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will...LPN/LVN, LSW, LCSW, or LMSW or license other than RN in accordance with applicable state law and Nursing… more