- Novo Nordisk Inc. (Albuquerque, NM)
- …elements in the market to identify and leverage business opportunities Analyze impact of managed care in the territory and its effect on prescribing decisions, ... align to audience needs Leverage understanding of impact of managed care in the territory and how...for the job titles are the following : Obesity Care Specialist I - $65,850 to $115,240… more
- Eisai, Inc (Nutley, NJ)
- …provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking through ... mild cognitive impairment due to Alzheimer's disease (AD) or mild AD. TheNeurology Account Specialist (NAS) will be part of a diverse team of sales professionals who… more
- Hawaii Pacific Health (Honolulu, HI)
- …and training, as well as internal peer equity. **Position** Specialist , Managed Care - Utilization Mgmt **Category** Administrative **Employment Type** ... As the Specialist , you will be responsible for providing comprehensive managed care information related to Hawai'i Pacific Health contracted health plans,… more
- LA Care Health Plan (Los Angeles, CA)
- … Utilization Management/Case Management experience in a hospital or HMO setting. Preferred: Managed Care experience performing UM and CM at a medical group or ... Utilization Management Nurse Specialist LVN II...At least 4 years of experience in a patient care setting and/or combination in utilization management,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job...experience in a hospital or HMO setting . Preferred: Managed Care experience performing UM and CM at ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will...of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge… more
- Abbott (Pleasanton, CA)
- …failure, allowing people to restore their health and get on with their lives. The ** Managed Care Sales Specialist ** is responsible for key account Managed ... Care sales targets include national payors, national networks, managed care organizations (HMO, PPO, POS, EPO),...the sales process to enhance payer awareness and increase utilization of Acelis Connected Health products and services. +… more
- Universal Health Services (Auburn Hills, MI)
- …MIDAS as needed. Faxes/ mails discharge packets. + Maintains a positive rapport with managed care providers; acts as a representative of Havenwyck Hospital. + ... Responsibilities Utilization Management - Precertification Specialist HAVENWYCK...proficient in Excel and Word applications. + Familiarity with managed health care process and medical terminology.… more
- WestCare Foundation (Henderson, NV)
- …and creating a clinical impression to present to all involved and approved parties, including managed care representatives + Knowledge of CPT, ICD 9 & ICD 10 ... Utilization Review Specialist Job Details Job...knowledge of HIPAA regulations and guidelines. + Knowledge of managed care and reimbursement principles. + Understanding… more
- MetroHealth (Cleveland, OH)
- …clinical or healthcare setting. Experience with and/or a strong understanding of managed care information systems. Knowledge of third-party payer information ... **Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries… more
- Immigration and Customs Enforcement (IN)
- …related to billing, coding, and utilization /case management [e.g., MCG Care Guideline Specialist , Certified Professional Medical Auditor (CPMA), or ... IHSC headquarters to meet mission initiatives. HPMU trains field medical coordinators, managed care coordinators and referral coordinators to improve processes… more
- Hackensack Meridian Health (Hackensack, NJ)
- …& levels of appeal iv. Root cause analysis & trends v. Participation in Managed Care Contracting & distribution of contract terms where appropriate 7. ... **Overview** The Senior Utilization Review Physician Specialist collaborates with...Management and Organizational Strategy a. Development & implementation of Utilization Management strategies to assure appropriate health care… more
- University of Washington (Seattle, WA)
- …. RN2, Utilization Management ... position will have partial/variable involvement with Harborview's Emergency Department. The Utilization Management Specialist RN2 is responsible for the ongoing… more
- Amergis (Detroit, MI)
- The Utilization Review Specialist is responsible for...in a fast paced environment + General knowledge of managed care delivery system + Complies with ... delivery system with a concentration ontasks that promote cost-effective quality care and cost containment inaccordance with various federal and/or state statutes,… more
- LA Care Health Plan (Los Angeles, CA)
- …internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and Support (MLTSS), Social Services, ... Enhanced Care Management Clinical Specialist II Job...care professionals in a hospital, medical group or managed care setting, such as a health… more
- Universal Health Services (Bloomington, IN)
- …all patients. Oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payers. Assures that ... Responsibilities The Utilization Management Specialist is responsible for executing the UM function, which includes the implementation of case management… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category:...care professionals in a hospital, medical group or managed care setting, such as a health ... to support the safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Medical/Provider Groups, ancillary vendors, industry-wide organizations (ie Department of Managed Health Care , Alameda County Health department, California… more
- AdventHealth (New Smyrna Beach, FL)
- …management Current working knowledge of discharge planning, utilization management, care management, performance improvement and managed care ... management Current working knowledge of discharge planning, utilization management, care management, performance improvement and managed care … more
- Novo Nordisk (Albuquerque, NM)
- …of patients with obesity to maximize sales within an assigned territory. The Obesity Care Specialist (OCS) must achieve sales goals by implementing marketing and ... identify and leverage business opportunities + Analyze impact of managed care in the territory and its...the job titles are the following : * Obesity Care Specialist I - $65,850 to $115,240… more
- Houston Methodist (Houston, TX)
- …the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, ... At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of optimal… more
