- Merck & Co. (North Wales, PA)
- …characterize disease burden and epidemiology, treatment patterns, healthcare resource utilization and costs, physician and patient satisfaction surveys, clinical and ... and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers, and Global Value Dossiers for… more
- Merck & Co. (Rahway, NJ)
- …characterize disease burden and epidemiology, treatment patterns, healthcare resource utilization and costs, physician and patient satisfaction surveys, clinical and ... and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers, and Global Value Dossiers for… more
- Merck & Co. (North Wales, PA)
- …observational studies to characterize disease burden and epidemiology, treatment patterns, health- care resource utilization and costs, physician and patient ... and economic modelling. Key responsibilities also include development of American Managed Care Pharmacy (AMCP) dossiers for US payers and Global Value Dossiers for… more
- Merck & Co. (Rahway, NJ)
- …observational studies to characterize disease burden and epidemiology, treatment patterns, health- care resource utilization and costs, physician and patient ... modelling. Key responsibilities also include overseeing the development of American Managed Care Pharmacy (AMCP) dossiers for US payers and Global Value Dossiers for… more
- Legend Biotech USA, Inc. (Baton Rouge, LA)
- …on the Job: 50%. Overnight travel, including some weekend commitments.Comfort with utilization of computer, company applications, and remote technology. The MSL ... for healthcare professionals treating oncology patients on clinical data, adverse event management , and mechanism of action for commercial and pipeline assets. The… more
- AmeriHealth Caritas Health Plan (Washington, DC)
- Role Overview Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and ... occasional overtime, and weekends based on business needs Responsibilities Conduct utilization management reviews by assessing medical necessity, appropriateness… more
- NORTH EAST MEDICAL SERVICES (Burlingame, CA)
- …Salary Range $128752.00 - $165048.00 Salary Description SUMMARY OF POSITION: The Utilization Management (UM) Nurse is a licensed nursing professional responsible ... UM Nurse will also work with the MSO Case Management team on coordinating patient care to...to solve the complex issues. Collaborates with MSO Case Management team and PCPs to ensure resource utilization… more
- Guidehealth (Philadelphia, PA)
- …Liaisons, Behavioral Health Liaisons, and Home Health Liaisons. Overseeing smooth Transitional Care Management for all patients discharged from in patient ... Value Based clinical initiatives. This includes but is not limited to case management , transitions of care , care coordination and continuity, provider/staff… more
- Morgan Stephens (Phoenix, AZ)
- Job Title: Physical Therapist (PT) - Utilization Management Organization: Managed Care Organization Must be licensed in Arizona Pay: Up to: $72.00 per hour ... Position Overview: The Managed Care Organization is seeking a qualified Physical Therapist (PT)...seeking a qualified Physical Therapist (PT) to join our Utilization Management Team. This position will primarily… more
- UnitedHealth Group (Houston, TX)
- …medicine (EBM) and managed care principles Preferred Qualifications: Hands-on utilization and/or quality management experience Project management or ... time for each member Work with medical director teams focusing on inpatient care management , clinical coverage review, member appeals clinical review, medical… more
- Fastly (Denver, CO)
- …early due to the volume of applicants. Manager, Security Technical Account Management Fastly is looking for an exceptional customer-centric leader to manage Security ... drive achievement of key performance indicators related to team performance, utilization , customer health, and retention Maintain and implement scalable processes… more
- UnitedHealth Group (Minnetonka, MN)
- …key drivers of health care trends (ie medical cost trends, utilization , etc.), utilization management program performance, and potential opportunities ... completing, and communicating the results of studies evaluating the performance of utilization management programs Use SAS/SQL to construct claims-based datasets… more
- Medtronic (Duluth, GA)
- …connected, compassionate world. A Day in the Life Careers that Change Lives This Remote Account Manager II is a US remote -based Medtronic Endoscopy Operating ... GI product portfolio. The position is focused on expanding the utilization of endoscopy products through market development and sales-oriented activities.… more
- Pair Team (Livermore, CA)
- …manager, nurse practitioner and Community Engagement Specialist with delegated tasks Collaborates on care issues with Enhanced Care Management team by ... appointments, managing referrals, and ensuring timely follow-ups Coordinate physical care management appointments through collaboration with external and… more
- Trinity Health (Livonia, MI)
- …Type: Full time Shift: Description: Epic Resolute Certified Application Coordinator REMOTE : position allows for work remote (90-95%) opportunity Resolute ... that support organizational objectives Consults with providers, clinicians, executives and management at all levels in order to provide support for decisions,… more
- Actalent (Kansas City, MO)
- …Your main role will be utilizing your clinical skills to complete utilization management reviews, including prior authorizations, coverage exceptions, and ... a team of your peers and other pharmacy professionals. Responsibilities Conduct utilization management reviews independently. Participate in a team of pharmacy… more
- UnitedHealth Group (Minneapolis, MN)
- …concurrent and/or retrospective overpayment identification audits Experience working with Utilization Management Experience with readmission reviews of claims ... SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum is a global organization that delivers care , aided by technology to help millions of people live healthier lives. The… more
- UnitedHealth Group (Cypress, CA)
- At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care . The work you do here ... of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable...validate renewals and request for proposals for accuracy including utilization & experience reporting. You'll enjoy the flexibility to… more
- CareAbout (Florham Park, NJ)
- …Location: Remote Reporting Relationships: This position reports to the Director of Care Management . Role Summary and Responsibilities: The Care Manager, ... support patients recently discharged from the hospital for transitional care management and/or an individualized care...lifestyle choices, adopt life-long healthy behaviors, close gaps in care , and reduce unnecessary ER utilization and… more
- Pyramid Consulting, Inc. (Thonotosassa, FL)
- Immediate need for a talented Care Management Support Coordinator II (Bilingual in Spanish). This is a 06+months contract opportunity with long-term potential ... and is located in US( Remote ; EST, CST). Please review the job description below...activities related to the medical and psychological aspects of utilization and coordinated care . Telephonic outreach attempts… more
