- Parexel (Nashville, TN)
- …Data Management Lead to join our team. If you have a passion for clinical research, strong project management skills, and a knack for data management , ... Science, OR equivalent industry experience. + 7+ years experience in pharmaceutical/biotech clinical data management / Biometrics ( clinical trial data… more
- Humana (Nashville, TN)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- HCA Healthcare (Nashville, TN)
- …and supply chain operations. ii) Value Analysis iii) Clinical Resource Management Program iv) Product standardization and utilization + Interacts and ... Do you want to join an organization that invests in you as a PRN Director Clinical Resource Management ? At HealthTrust, a division of HCA, you come first. HCA… more
- HCA Healthcare (Nashville, TN)
- … and supply chain operations. 2. Value Analysis and Clinical Resource Management Program 3. Product standardization and utilization 4. Produce and provide ... reviewing and optimizing the current GPO contract portfolio, developing comprehensive clinical and utilization protocols, and developing and executing product… more
- Danaher Corporation (Nashville, TN)
- …includes some of the following: infection detection/control, sepsis care, decision support, utilization management , case management , ED patient workflow, ... - innovating at the speed of life. As a global leader in clinical diagnostics, Beckman Coulter Diagnostics has challenged convention to elevate the diagnostic… more
- Molina Healthcare (Bowling Green, KY)
- …Active, unrestricted State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care ... management initiatives and analytical studies aimed at optimizing utilization of medical resources and maximizing operational efficiencies. + Engages with… more
- Deloitte (Nashville, TN)
- …plans for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education ... clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG… more
- Evolent (Nashville, TN)
- … Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Vanderbilt University Medical Center (Nashville, TN)
- …educational programs that advance the professional development, knowledge and effectiveness of staff and clinical pharmacists. + The responsibilities listed are ... plan to meet the individualized drug therapy needs of the patient. The clinical specialist is responsible for leading efforts in the prevention and reporting of… more
- Evolent (Nashville, TN)
- …independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. Acts as a member advocate by ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Molina Healthcare (Bowling Green, KY)
- JOB DESCRIPTION Job SummaryProvides support for pharmacy Medication Therapy Management (MTM) activities. Contributes to overarching pharmacy strategy to ensure ... in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices. *… more
- Elevance Health (Nashville, TN)
- …minimum of 4 years managed care experience and requires a minimum of 2 years clinical , utilization review, or case management experience; or any combination ... providing services in multiple states. **Preferred Skills, Capabilities & Experiences:** + Utilization management experience. + Strong of computer skills. For… more
- Highmark Health (Nashville, TN)
- …per week (Tuesday-Thursday).** This role supports the full application product lifecycle for ** clinical and utilization management software** , with a ... and technical teams. They function as a pivotal bridge, translating high-level ** clinical and utilization management software** business needs into… more
- Molina Healthcare (Bowling Green, KY)
- …national, state, and local laws and regulatory requirements affecting the medical and clinical staff . + Marketplace UM reviews + MD licenses required for ... resource management . + Develops and implements a Utilization Management program and action plan, which...clinical lead, the medical director, and quality improvement staff . + Facilitates conformance to Medicare, Medicaid, NCQA and… more
- Molina Healthcare (Bowling Green, KY)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Evolent (Nashville, TN)
- …Cardiologist)** Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical ... appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and clinical staff to address complex cases and… more
- HCA Healthcare (Hendersonville, TN)
- …hospital departments and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of ... to join an organization that invests in you as a(an) Director Case Management ? At TriStar Hendersonville Medical Center, you come first. HCA Healthcare has committed… more
- Evolent (Nashville, TN)
- …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Evolent (Nashville, TN)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Evolent (Nashville, TN)
- …Doing:** As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** . Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
