- Novo Nordisk Inc. (Murfreesboro, TN)
- …sales and marketing resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company policy Analyze and ... experience required Intermediate computer skills required (Windows, Word, Excel); prior computer experience using sales data/call reporting software ideal Must… more
- Novo Nordisk Inc. (Phoenix, AZ)
- …appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved ... engaging customers Intermediate computer skills required (Windows, Word, Excel); prior computer experience using sales data/call reporting software ideal Knowledge… more
- Novo Nordisk Inc. (Annapolis, MD)
- …and adapting to business priorities Educate HCPs to increase product utilization , optimize treatment, and align with evidence-based medicine and guidelines, while ... Ability to work independently in a field-based role is required Prior computer experience using sales data/call reporting software preferred Bilingual preferred… more
- Novo Nordisk Inc. (Boston, MA)
- …collateral development Achieve or exceed assigned sales objectives through effective utilization of all available resources, strategies and tactics Collaborates with ... make decisions, and operate your business activities with minimal supervision Prior computer experience using sales data/call reporting software preferred This… more
- Novo Nordisk Inc. (Boston, MA)
- …and adapting to business priorities Educate HCPs to increase product utilization , optimize treatment, and align with evidence-based medicine and guidelines, while ... Ability to work independently in a field-based role is required Prior computer experience using sales data/call reporting software preferred Bilingual preferred… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews ... coverage while working remotely. Primary Responsibilities * Perform prospective utilization reviews and first level determinations for members using evidenced… more
- Elevance Health (San Antonio, TX)
- …and personalized support throughout the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior Authorization **Location:** ... immediate support. **Build the Possibilities. Make an extraordinary impact.** The ** Utilization Management Representative II - Prior Authorization** is… more
- Centene Corporation (Jefferson City, MO)
- …members. **Position Purpose:** Oversee operations of the referral management, telephonic utilization review, prior authorization, and various related functions ... compliance with National Committee for Quality Assurance (NCQA) standards for utilization management functions, prior authorization and concurrent review units… more
- Integra Partners (Troy, MI)
- …Nurses/Medical Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorizations and appeals. Rate of Pay: ... $19.00/hour JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Coordinator's responsibilities include but are not limited to: + Monitor incoming faxes + Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes + Verify eligibility… more
- Commonwealth Care Alliance (Boston, MA)
- …Knowledge, Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent and retrospective ... 013650 CCA-Auth & Utilization Mgmt Position Summary: Commonwealth Care Alliance's (CCA)...Management * Oversees clinical decision review for services requiring prior authorization in a variety of clinical areas, including… more
- US Tech Solutions (Chicago, IL)
- …as an RN + Registered Nurse in state of residence + Must have prior authorization utilization experience + Experience with Medcompass **Skills:** + MUST HAVE ... and Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF...Prior Authorization? + Do you have experience with Utilization Review? + Do you have an Active Registered… more
- CVS Health (Austin, TX)
- …work schedules will include holidays and evening hours **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care ... work Monday through Friday, 10:00am to 7pm EST with occasional holiday rotation. Utilization Management is a 24/7 operation and work schedules will include holidays… more
- CVS Health (Springfield, IL)
- …Must be willing to work 8-5pm local time. **Preferred Qualifications** + Prior authorization utilization experience preferred + Outpatient Clinical experience + ... opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external… more
- US Tech Solutions (May, OK)
- …inpatient hospital experience . Registered Nurse in state of residence . Must have prior authorization utilization experience . Able to work in multiple IT ... and Medicare/Medicaid knowledge. . MUST HAVE UM experience, inpatient utilization management review. . MUST HAVE 1 YEAR OF...knowledge of Milliman/MCG. . MUST HAVE 6 months of Prior Authorization. Education: . Active and unrestricted RN licensure… more
- CVS Health (St. Paul, MN)
- …+ 3+ years of Nursing experience. Preferred Qualifications + Prior authorization utilization management/review experience preferred Outpatient Clinical ... opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . + Consults and lends expertise to other internal and external… more
- Humana (North Augusta, SC)
- …clinical acute care, skilled nursing, rehab or transitional care experience. + Prior experience in utilization management. + Intermediate to advanced proficiency ... and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Nurse who utilizes clinical nursing skills to support the coordination,… more
- Actalent (Dallas, TX)
- …In this role, you will utilize your clinical skills to conduct utilization management reviews, including prior authorizations, coverage exceptions, and quantity ... evaluated every six months for extension. Responsibilities + Conduct utilization management reviews, including prior authorizations, coverage exceptions,… more
- Actalent (Kansas City, MO)
- …In this role, you will utilize your clinical skills to conduct utilization management reviews, including prior authorizations, coverage exceptions, and quantity ... evaluated every six months for extension. Responsibilities + Conduct utilization management reviews, including prior authorizations, coverage exceptions,… more
- Molina Healthcare (San Antonio, TX)
- …family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and ... efficiently and effectively. These pharmacists may also be involved in providing utilization management/ prior authorization services. Key duties include any or… more
- Humana (Richmond, VA)
- …a team **Preferred Qualifications** + Bachelor's degree + Previous experience in prior authorization, claims, and/or utilization management in healthcare, health ... part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination,… more
