- CaroMont Health (Gastonia, NC)
- …RAC for reversal of original determination. May serve on the Medical Record/ Utilization Review Committee, providing detailed logs of denial activity and appeal ... practice in NC (NC license or multi-state (compact) license). Certification in Utilization Review / Management, Quality and/or Case Management preferred. Minimum… more
- CaroMont Health (Gastonia, NC)
- Job Summary: The Pre-Authorization Specialist is a member of the Utilization Review Department who is responsible for verifying eligibility, obtaining ... authorizations for care, via phone, fax, or payer websites. The Pre-Authorization Specialist provides detailed and timely communication to both payers and clinical… more
- Novant Health (Charlotte, NC)
- Job Summary ACUTE CARE Clinical Pharmacist Specialist Infectious Disease Novant Health is seeking a Clinical Pharmacist Specialist Infectious Disease, to join ... wellness. Essential functions include: + Facilitates pharmaceutical care services, medication utilization systems within assigned services and care areas to ensure… more
- Lowe's (Charlotte, NC)
- …in a clinical position. + 3-5 Years of Experience as a Case Manager or Utilization Review Nurse in worker's compensation + Experience in a clinical position + ... will be responsible for medically managing a minimum caseload of 65 including review of claims identified for Medicare Set-Aside. **What you will do** + Manage… more