- Insight Global (Mayfield Heights, OH)
- …Agile/Scrum experience Advanced domain knowledge of case, disease and utilization management /coordination/assessments, HEDIS quality and HIE Ability to ... dynamics toward the successful completion of requirements development and management including facilitation of requirements gathering, review, acceptance, prioritization,… more
- Molina Healthcare (Akron, OH)
- …trends in drug utilization and identify potential targeted utilization management activities. + Works with Health Care Services (eg, with data manager, ... efficiently and effectively. These pharmacists may also be involved in providing utilization management /prior authorization services. Key duties include any or… more
- Molina Healthcare (Akron, OH)
- …and/or Tableau and data management + Knowledge of healthcare operations ( utilization management , disease management , HEDIS quality measures, claims ... team through analyzing key business issues related to cost, utilization and revenue for multiple Molina Healthcare products. Designs...signs of trends or other issues related to medical care costs. + Work with clinical, provider network and… more
- CDM Smith (Akron, OH)
- …of cloud technologies, including design patterns, planning, configuration, and resource management in Microsoft Azure and other cloud platforms. * Develop DevSecOps ... (AAD), RBAC, IAM configuring role assignments, conditional access, and identity management . * Incorporate security best practices into cloud architecture and ensure… more
- Molina Healthcare (Akron, OH)
- …comply with CMS guidelines. These staff may also be involved in providing utilization management /prior authorization services as needed. * Supervises the unit's ... (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management ), clinical pharmacy… more
- Molina Healthcare (Akron, OH)
- …increasingly complex data problems in quantifying, measuring, and analyzing financial/performance management and utilization metrics. + 1-3 Years of experience ... for Medicaid, Marketplace and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates. + Assist… more
- Molina Healthcare (Akron, OH)
- …teams that support one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical ... necessity, etc.), case management , transition of care , health management and/or member assessment. * Typically, through one or more direct report… more
- Molina Healthcare (Akron, OH)
- …operational efficiency and decision-making capabilities. * **RAG Pattern Utilization :** Employ retrieval-augmented generation patterns to improve the performance ... teams to build ML models which helps in improving Star ratings, reduce care gap and other business objectives. * Present complex analytical information to all… more
- Grifols Shared Services North America, Inc (Akron, OH)
- …countries and regions. **Overview:** The primary responsibility of the Bleeding Management Hospital Specialty Sales Representative (HSSR) is to represent key ... products within the Bleeding Management product portfolio with a primary responsibility for the...and customer stakeholders to influence uptake for a new standard-of- care and product adoption in the treatment of their… more
- Sanofi Group (Cleveland, OH)
- …of short- and long-term business plans that will optimize appropriate coverage, coding, Utilization Management , payment of and patient access to Sanofi products. ... **Job Title:** Regional Account Director, OH **Location:** Remote /Field Based **About the Job** The Regional Account Director reports to the Regional Accounts Leader… more
- Philips (Orange Village, OH)
- …needs and challenges of individual customers. + **Customer Relationship Management :** You will maintain positive and productive relationships with customers, ... directly with customers to offer support and address inquiries. Provide remote or onsite assistance, guiding clinicians through procedures, troubleshooting issues,… more
- PNC (Brecksville, OH)
- …Cincinnati, OH, Cleveland, OH, Kalamazoo, MI, or Pittsburgh, PA. This is a remote position that must sit within the PNC footprint. Certain job responsibilities may ... ensures alignments with the bank's and unit's risk appetite and risk management framework. * Uses comprehensive view of organizational processes to facilitate the… more
- GE HealthCare (Cleveland, OH)
- …organizations use MIM(R) to give patients more precise, personalized care . https://www.mimsoftware.com/ As a Clinical Application Support Specialist (CASS) you ... training sessions for team members, along with cross-functional teams + Use remote technologies to diagnose and resolve customer concerns and to guide customers… more