- Humana (Raleigh, NC)
- …where your clinical expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager , you will spearhead audit and validation ... relevant coding. + Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management....skills to make an impact** **Required Qualifications** + Registered nurse (RN). + 5 or more years of clinical… more
- Elevance Health (Durham, NC)
- **Telephonic Nurse Case Manager Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager Senior** is responsible for care management within… more
- CVS Health (Raleigh, NC)
- …travel if a plan sponsor requests pharmacist attendance for an onsite visit/assessment/ audit . The Pharmacy Program Manager role includes: -Collaborate with an ... with heart, each and every day. The Pharmacy Program Manager is an individual contributor (non-people manager )...interdisciplinary care management team ( nurse case managers, medical directors, dietitians, social workers) to… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role The Manager , Utilization Management (UM) will manage the Utilization Management team consisting of Clinicians and Non-Clinical support staff. The ... for team members. + Partner with Clinical Program leaders to address audit results to ensure compliance with regulatory and internal policy requirements. +… more