- CVS Health (Austin, TX)
- …strategic initiatives, along with a team of medical coders/nurses supporting Aetna 's Special Investigations Unit. Key Responsibilities: + Leadership: Leads a team ... distribution and exposure to wide range of reviews. Assist with business opportunities aligned to inventory allocation and prioritization. + Quality Control… more
- CVS Health (Austin, TX)
- …Manage Third Party Risk Governance process for your assigned TPA(s). + Manage ongoing Aetna compliance review process for your assigned TPA(s). + Manage monthly ... manages competitive and complex contractual relationships with TPAs and/or business partners in Europe, APAC, Africa and Middle East...TPA networks are timely reviewed and uploaded on internal Aetna systems. + Ensure TPA guides, country guides and… more
- CVS Health (Austin, TX)
- …Summary** This Case Manager - Registered Nurse (RN) position is with Aetna 's National Medical Excellence (NME) team and is a fully remote position. Candidates ... both Case Management and Utilization Management. The RN Case Manager is responsible for telephonically and/or face to face...facilitates integrative functions as well as smooth transition to Aetna programs and plans. + Applies clinical judgment to… more