Utilization Management Specialist
Blue Cross NC(23 days ago)
About this role
A Utilization Management Specialist at Blue Cross NC is a member of the Government Pharmacy Utilization Management Operations Team, focused on supporting utilization management processes and ensuring adherence to regulatory standards. The role contributes to accurate processing of pharmacy-related utilization decisions and assists with departmental administrative workflows to support timely operations.
Required Skills
- Non-Clinical Review
- Customer Communication
- Documentation
- Provider Outreach
- Authorization Review
- Care Management
- Fax Retrieval
- CMS Compliance
- Customer Service
Qualifications
- High School Diploma or GED
About Blue Cross NC
bluecrossnc.comBlue Cross NC makes health insurance easy. Discover employer, individual, family, Medicare & Medicaid plans from Blue Cross NC. Better care starts here.
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