- CVS Health (Jefferson City, MO)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Central or Mountain… more
- CVS Health (Jefferson City, MO)
- …+ 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
- Highmark Health (Jefferson City, MO)
- …needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, ... while also being capable of developing technical solutions. The consultant will act as a senior resource within the...the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The… more
- SSM Health (St. Louis, MO)
- …supply database validation, medical staff profiling (eg, age, specialty, utilization modeling/forecasts) and other key metrics required to support strategic ... rosters reflecting all providers and sites of care used in Master Data Management (MDM). + Supports strategy and regional leaders in conducting research and… more
- Deloitte (Kansas City, MO)
- Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk ... for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education tools as… more
- Elevance Health (MO)
- … clinical /non- clinical activities. Will also be responsible for utilization review/ management . May be responsible for developing and implementing programs ... live in Indiana.** The **Medical Director** will have program management responsibilities including clinical policy development, program… more
- Elevance Health (St. Louis, MO)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May...an entire clinical program and/or independently performs clinical reviews. + Typically has program management … more
- Cardinal Health (Jefferson City, MO)
- …payers, pharmacists and manufacturers for integrated care coordination and better patient management . Backed by nearly 100 years of experience, with more than 40,000 ... currently have a career opening for a Reimbursement Solutions Analyst. **What Clinical Operations contributes to Cardinal Health** Clinical Operations is… more