Utilization Review Specialist jobs in Cary, NC

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FINANCE & STRATEGY ANALYST, SR - CORPORATE FINANCE
UNC Health Care - 578 reviews - Raleigh, NC 27601
Reviews organization’s financial reports, identifying trends and opportunities for performance improvement....
MANAGER - HOMECARE SERVICES
UNC Health Care - 578 reviews - Durham, NC 27703
Completes management/office staff performance reviews in a timely manner. Develops the home infusion nursing program at UNC Homecare Specialists....
MANAGER CARE MANAGEMENT-U - UNCH CARE MANAGEMENT
UNC Health Care - 578 reviews - Chapel Hill, NC 27517
Provides management direction to Inpatient Social Work Care Managers, Care Managers, Utilization Managers, Clinical Social Workers, Clinical Authorization...

Benefit Specialist II

FHI 360 - 126 reviews - Durham, NC
Management reserves the right to review and revise this document at any time. Analyzes participation and utilization for all benefits on a monthly, quarterly...

PATIENT FINANCIAL SERVICES REPRESENTATIVE - PHARMACY BENEFIT...

UNC Health Care - 578 reviews - Morrisville, NC 27560
Pharmacy Benefit Management Operations Specialist. Participate in and operationalize solutions to address inappropriate utilization, improve outcomes and...

Credentialing Specialist

Pivot Physical Therapy - 47 reviews - Raleigh, NC
Review provider credentialing files and work with providers to obtain the necessary missing, incomplete and expiring items....

Care Manager I (RN) Utilization Review

Centene - 885 reviews - Raleigh, NC 27617 (Central area)
Utilization Review, prior authorization experience is highly preferred. Coordinate services between Primary Care Physician (PCP), specialists, medical providers...

Substance Use Disorder Specialist

Easter Seals UCP North Carolina & Virginia, Inc. - 1,576 reviews - Raleigh, NC 27609 (Falls Of Neuse area)
Prepares and presents documentation for utilization review. Participates in peer review. Conducts comprehensive substance abuse assessments considering the...

Medical Coding Specialist - East Coast

Landmark Health - 34 reviews - Raleigh, NC
2+ year experience coding ICD.9/ICD.10 for HCC utilization. Retrospective review of records and coded data for audit....

Quality Assurance Specialist I

Sierra Nevada Corporation - 124 reviews - Durham, NC
Contract review for quality requirements. The Quality Assurance Specialist is involved in the Change Control Board and the Material Review Board as a voting...

Operations Specialist 2

IQVIA - 82 reviews - Durham, NC
Preparation of material for submission of secondary review. Contribute to achievement of departmental goals e.g. utilization realization and productivity...

Operations Specialist 2 / Operatiions Specialist 1 - Drug Sa...

QuintilesIMS - 1,006 reviews - Durham, NC
Preparation of material for submission of secondary review. Contribute to achievement of departmental goals e.g. utilization realization and productivity...

Peer Support Qualified Professional

Sunrise Clinical Associates,PLLC - Durham, NC
Participates in scheduled Utilization Reviews with Clinical Director, QA/QI Director and Program Supervisor....
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