• Utilization Management

    CVS Health (Frankfort, KY)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
    CVS Health (10/21/25)
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  • Care Review Clinician , PA (RN)

    Molina Healthcare (Lexington, KY)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT… more
    Molina Healthcare (10/18/25)
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  • Regional Director, Care Integration Strategy…

    CenterWell (Frankfort, KY)
    …(ie, single resource) offerings for bridging or episodic support for medication management , chronic disease management , deprescribing, behavioral health ... clinician and patient pain points in day-to-day panel management + Excellence communication skills, including follow-through communication, executive… more
    CenterWell (10/22/25)
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