utilization management Jobs in raleigh, nc

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Registered Nurse | Utilization Management Appeals Nurse | Remote | Contract

Walker Healthforce

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Remote

Contract

Utilization Management Appeals Nurse | 2 years experience | Remote | Contract Walker Healthforce is seeking a Utilization Management Appeals Nurse with 2 years of experience to support a healthcare client based out of New Jersey. This is a 6-month contract opportunity. START DATE: 6/1/2025 HOURS/SCHEDULE: 8am-5pm EST Monday- Friday WORKER TYPE: W2 CORE REQUIREMENTS: Minimum of two (2) years clinical experience 3 - 5 years of experience with a background in either Utilization Management, Prior
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Posted 54 days ago | Updated 4 days ago

Registered Nurse | Utilization Management Appeals Nurse | Remote | Contract

Walker Healthforce

•

Remote

Contract

Utilization Management Appeals Nurse | 3 years | Remote | Contract Walker Healthforce is seeking a Utilization Management Appeals Nurse with 3 years of experience to support a healthcare client based out of New Jersey. This is a 6-month contract opportunity. START DATE: ASAP WORKER TYPE: W2 CORE REQUIREMENTS:Minimum of 3 years clinical experience.3 years experience in the health care delivery system/industry.Must have effective verbal and written communication skills and demonstrate the abilit
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Posted 4 days ago

Medical Director - Clinical Review - Remote

Optum

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Remote or Raleigh, North Carolina, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Care Manager - Behavioral Health

EnpowerTek

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Remote

Full-time

Job Title: Care Manager - Behavioral HealthLocation: California (must reside and be licensed in California)Schedule: Monday Friday, 8:00 5:00 pm Job Overview:We are seeking experienced Care Managers with a behavioral health focus to join a growing team supporting mental health and substance abuse programs. You will monitor inpatient and outpatient services, conduct concurrent reviews, and ensure medical necessity and quality of care for members. This role will also engage in crisis intervention,
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Posted 3 days ago

Care Manager - Health Plan

EnpowerTek

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Remote

Full-time

Job Title: Care Manager - Health PlanLocation: Remote (CST hours)Schedule: Monday Friday, 8:00 5:00 pm CST Job Overview:This position focuses on comprehensive care management, including assessment, care planning, and coordination of services for members with moderate to high behavioral health needs. The Care Manager will oversee the delivery of person-centered care plans, monitor outcomes, and collaborate with internal and external resources to ensure quality, cost-effective services. Key Respon
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Posted 3 days ago

Medical Director - Clinical Review - Remote

Optum

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Remote or Chicago, Illinois, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Philadelphia, Pennsylvania, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or St. Louis, Missouri, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Baltimore, Maryland, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Houston, Texas, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Phoenix, Arizona, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Nashville, Tennessee, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Boston, Massachusetts, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Tampa, Florida, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Bloomington, Minnesota, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Indianapolis, Indiana, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Atlanta, Georgia, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - Remote

Optum

•

Remote or Dallas, Texas, USA

Full-time

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us ad
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - CA, AZ or NM licensure - Remote

Optum

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Remote or San Diego, California, USA

Full-time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health op
Posted 6 hours ago | Updated 5 hours ago

Medical Director - Clinical Review - CA, AZ or NM licensure - Remote

Optum

•

Remote or Las Cruces, New Mexico, USA

Full-time

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health op
Posted 6 hours ago | Updated 5 hours ago