- CVS Health (Annapolis, MD)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CareFirst (Baltimore, MD)
- …**Experience:** 5 years experience in business development, operational technology support, Utilization Management (UM) operations, Clinical Product ... role will focus specifically on optimizing end-to-end business processes within Utilization Management . **ESSENTIAL FUNCTIONS:** + Provide deep subject matter… more
- CVS Health (Annapolis, MD)
- …+ Human Resource and/or Supervisory experience. + Case management , Utilization Review, or Utilization Management background preferred. **Education** ... Friday, 11:00 am to 8:00 pm Eastern Time.** The Consultant provides management consultation to corporate clients...clinical assessments and triage into care. Performs case management across scope of all types of management… more
- CVS Health (Annapolis, MD)
- …of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare ... knowledge and expertise to enhance their understanding of utilization management principles and improve their clinical decision-making. Contributes to the… more
- Cardinal Health (Baltimore, MD)
- …a highly regulated industry + Previous sales experience selling to physicians, clinical end-users, materials management , and C-suite desired + Strong preference ... Job Description **Senior Consultant , Product Sales Specialist - NPHS** **The territory covers Pennsylvania (Philadelphia, Pittsburgh and Allentown), Maryland… more
- Highmark Health (Annapolis, MD)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- CareFirst (Baltimore, MD)
- …psychiatric setting. **Preferred Qualifications:** + 2 years experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Nurse completes research, basic analysis, and...regulatory and accreditation requirements, understanding of appeals process and utilization management , and systems software used in… more
- CareFirst (Baltimore, MD)
- …or similar clinical experience OR 5 years experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross BlueShield, or ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate...regulatory and accreditation requirements, understanding of appeals process and utilization management , and systems software used in… more
- Trinity Health (Silver Spring, MD)
- …appropriate utilization /level of care (LOC), length of stay (LOS) management , patient flow/throughput management , appropriate clinical documentation, and ... LOC status, LOS management , continued stay decisions, clinical review of patients, utilization review activities,...planning (DP) advise and quality issues. Functions as a consultant and resource to other Physician Advisors and primary… more
- Veterans Affairs, Veterans Health Administration (Linthicum Heights, MD)
- …may conduct psychiatric evaluations, develop treatment plans, implement treatment, and provide clinical management for a variety of complex mental health ... studies and/or for adjunctive psychosocial interventions. Perform duties as a practitioner and consultant in Psychiatry within a variety of clinical settings but… more
- Johns Hopkins University (Baltimore, MD)
- …of acute and long-term effects of radiation and provides accurate and timely management for such side effects. + Provides education to patient and family members ... + Conducts telehealth visits as appropriate for follow-up care, symptom management , or triage, ensuring timely communication and documentation in the EMR.… more