- Evolent Health (Providence, RI)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- CenterWell (Providence, RI)
- …payer contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and ... and many of the delegation oversight listed above + Home infusion Therapy Accreditation and Pharmacy accreditation for infusion nursing services, NABP, URAC,… more
- Evolent Health (Providence, RI)
- …Be Doing:** As a Physician Clinical Reviewer, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Brockton Hospital (Brockton, MA)
- …with Chief Medical Officer (CMO). Develops systems to ensure optimal therapeutic drug utilization . Anticipates and creates plans to manage new drug costs and supply ... policies, state and federal regulations for all pharmacy locations, and accreditation body requirements, including Department of Public Health (DPH), Board of… more