- 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 (Philadelphia, PA)
- …experience in ICU, ED, Med-Surg, pediatrics, behavioral health, or similar. Prior Utilization Management or managed care experience preferred. Strong ... services. Discover more about us at www.amerihealthcaritas.com. Join a mission-driven Utilization Management team where your clinical expertise helps shape… more
- Guidehealth (Chicago, IL)
- …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
- UnitedHealth Group (Minneapolis, MN)
- …medicine (EBM) and managed care principles Preferred Qualifications: Hands-on utilization and/or quality management experience Project management or ... Fortune 4 industry leader. We are currently seeking a Utilization Management Medical Director to join our...groups of nurses and support staff to manage inpatient care utilization . You'll enjoy the flexibility to… more
- Veterans Health Administration (Houston, TX)
- …and Aspire to Quality standards Experienced manager in Utilization Management . Certified Professional in Health Care Quality (CPHQ). Physical Requirements: ... Summary The Registered Nurse Quality & Patient Safety Nurse Manager - Utilization Management functions as a clinical expert and is responsible and accountable… more
- Blue Shield of California (Oakland, CA)
- …for the FEP membership Support VP, Medical Management and Medical Directors in Utilization Management in coordinating the care of FEP membership to ... policy to accelerate the emergence of a value-based health care system in California. The Senior Medical Director FEP...management of the physician processes in support of utilization management and transactional functions for Federal… more
- Envista (White Plains, NY)
- …accounts. Ability to effectively manage assigned accounts in terms of driving utilization , customer relationship management , problem resolution, and business and ... sales and educational strategies, aids, and approaches, to increase customer utilization and educational activity in their territory. Influence doctor and staff… more
- UnitedHealth Group (Metairie, LA)
- …and healthcare economics analyses. They will also provide oversight of the performance of utilization management including the Inpatient Care Management ... The health plan CMO will work collaboratively in these activities with utilization management medical directors and regional CMOs. The Health Plan… more
- Molina Healthcare (Long Beach, CA)
- …with CMS guidelines. These staff may also be involved in providing utilization management /prior authorization services as needed. *Supervises the unit's daily ... (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy… more
- Pair Team (Berkeley, 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
- UnitedHealth Group (Louisville, KY)
- …years of ICUE experience 1+ years of Linx experience Utilization Management experience Document review experience Managed Care experience Dual diagnosis ... UnitedHealth Group, this includes offering an innovative new standard for care management . It goes beyond counseling services and verifies referrals to programs… more
- Children's Mercy KC (Kansas City, MO)
- …of daily operations of the case management department which includes utilization management , care progression and discharge planing promoting ... Degree in Health Administration and 5-7 years experience in Management , Care Management , Utilization...families. Learn more about Children's Mercy benefits. Starting Pay Remote Work/Work from Home This position is not eligible… more
- Actalent (St. Paul, MN)
- …In this role, you will utilize your clinical skills to conduct utilization management reviews, including prior authorizations, coverage exceptions, and quantity ... contracts evaluated every six months for extension. Responsibilities Conduct utilization management reviews, including prior authorizations, coverage exceptions,… more
- UnitedHealth Group (Eden Prairie, MN)
- …Our clients seek transformational solutions to managing clinical operations - including Care Management , Workflow, and Clinical Variation Reduction - to reduce ... to start Caring. Connecting. Growing together. The Advisory Director, Care Transformation - Remote will be a...plans to drive effective clinical and non-clinical sourcing and utilization Support the creation of sales pursuit materials and… more
- UnitedHealth Group (Fort Washington, PA)
- … management with recommendations and advice on evaluation and projection of utilization and health care costs, including review of Medicare Payment rates, ... At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care . The work you do here… more
- Actalent (St. Louis, MO)
- …roles after 18-24 months. What You'll Do Conduct independent reviews of utilization management requests Assess coverage requests with client-specific clinical ... pharmacy professionals making real-time decisions that directly impact patient care . In this fully remote role, you'll use your clinical expertise to review and… more
