- Novo Nordisk Inc. (Plainsboro, NJ)
- …to make a difference? The Position Position provides field coaching, mentorship and management to the field-based Medical Liaisons, and develops and implements ... Medical Liaisons Participates in Marketing and Sales meetings and national medical meetings; interacts with CTM and DEP management and external task… more
- Novo Nordisk Inc. (Walnut Creek, CA)
- …Educators, Medical Liaisons) covering the same geographic areas. The Specialty Field Sales Representative actively shares information and plans to develop a ... HCPs (eg HEP/GI ) and key customers. Relationships Externally, the Specialty Field Sales Representative maintains relationships with physicians, pharmacists, nurses,… more
- Novo Nordisk Inc. (Boston, MA)
- …the following: Pediatric Endocrinologists, Pediatric Endocrinology Nurses, Specialty Pharmacies, wholesalers/distributors and Patient and Professional Associations. ... Internally, this position will collaborate with STARS Medical Liaisons, and STARS Account Managers. Essential Functions Attention to detail, thorough, timely and… more
- CVS Health (Pittsburgh, PA)
- …we do it all with heart, each and every day. **Position Summary** The Medical Specialty Clinical Pharmacist will be responsible for development and execution of ... clinical content for medical specialty programs and services across our...long-term and ongoing departmental and enterprise initiatives. Knowledge of utilization management interventions including prior authorization, step… more
- Commonwealth Care Alliance (Boston, MA)
- …as the lead for CCA's Utilization Review functions working closely with other medical management team members. + Support the development of utilization ... for providing leadership and subject matter expertise to our utilization management (UM) group. This role is...licensed to practice in MA. + Board-certified in their medical specialty , required. + Must be clear… more
- Ventura County (Ventura, CA)
- …knowledge of: + The theory, techniques, and practices of professional nursing within utilization management ; + medical terminology and hospital routine and ... Per Diem Registered Nurse II/III - Utilization Management VCMC Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5009956) Apply Per Diem… more
- MVP Health Care (Rochester, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Medical Director, Post-Acute Care Utilization Management ** to join ... reviews, continued stay requests, and handling first-level appeals. + Collaborate with Utilization Management , Case Management , Quality Department and other… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets ... Unit is primarily responsible for the evaluation of the medical necessity, appropriateness, and efficiency of the use of...facilities under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for… more
- Commonwealth Care Alliance (Boston, MA)
- …and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM)… more
- CVS Health (Charleston, WV)
- …compassionate. And we do it all with heart, each and every day. ** Utilization Management Clinical Consultant** **Remote - West Virginia** Schedule is ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is… more
- Centene Corporation (Jefferson City, MO)
- …complex and often conflicting requirements. + Oversee the operations of utilization management , reconciliation coordination, concurrent review (telephonic and ... and the connections departments to address concerns regarding compliance with medical management requirements + Maintain compliance with National Committee… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates,...requests by Providers. Acts as a department resource for medical service requests /referral management and processes.… more
- AmeriHealth Caritas (LA)
- **Responsibilities:** Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and ... will also be counted upon to: + Conduct utilization management reviews by assessing medical...most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
- Guthrie (Troy, PA)
- …CPT/ICD coding, medical record or chart auditing, and experience in utilization management processes preferred. Knowledge of computer applications (such as ... to a $15,000.00 Sign on Bonus! Summary The LPN Utilization Management (UM) Reviewer, in collaboration with...specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical … more
- CVS Health (Frankfort, KY)
- …SEE REQUIRED QUALIFICATIONS FOR LICENSING DETAILS_** This is a fulltime remote Utilization Management Clinical Consultant opportunity with Aetna Better Health of ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is… more
- CVS Health (Baton Rouge, LA)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. - Applies critical thinking and is ... external constituents in the coordination and administration of the utilization /benefit management function. **Required** **Qualifications** - Licensed… more
- CVS Health (Richmond, VA)
- …med surg or specialty area * Managed Care experience preferred, especially Utilization Management * Preference for those residing in EST zones **Education** ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- CVS Health (Raleigh, NC)
- …med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in ET zones **Education** ... and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- AmeriHealth Caritas (Washington, DC)
- …Overview:** Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient ... occasional overtime, and weekends based on business needs **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity,… more
- Penn State Health (Hershey, PA)
- …**SUMMARY OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS and DOH, ... **Penn State Health** - **Hershey Medical Center** **Location:** US:PA: Hershey **Work Type:** Full...processes. The incumbent is responsible for identifying and communicating utilization management concerns to physician and administrative… more
