- CVS Health (Nashville, TN)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Nashville, TN)
- …+ 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 (Nashville, TN)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- Elevance Health (Nashville, TN)
- …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
- Covenant Health Inc. (Knoxville, TN)
- …the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care ... Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period,...quality through the collaborative development of practice guidelines and clinical pathways that support quality improvement activities. The RN… more
- Covenant Health Inc. (Harriman, TN)
- …the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care ... and quality through the collaborative development of practice guidelines and clinical pathways that support quality improvement activities. The RN Care Manager… more
- Covenant Health Inc. (Harriman, TN)
- …the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care ... and quality through the collaborative development of practice guidelines and clinical pathways that support quality improvement activities. The RN Care Manager… more
- Covenant Health Inc. (Lenoir City, TN)
- …the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care ... or changes the plan as needed to meet the patient's needs. Outcomes/ Clinical /Fiscal/Resource Management : + Utilizes statistical analysis techniques to measure … more
- Covenant Health Inc. (Knoxville, TN)
- …the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care ... or changes the plan as needed to meet the patient's needs. Outcomes/ Clinical /Fiscal/Resource Management : + Utilizes statistical analysis techniques to measure … more
- Covenant Health Inc. (Knoxville, TN)
- …the patient care setting, coordinating education of staff and patients and serving as a clinical resource and consultant to the health care team. The RN Care ... or changes the plan as needed to meet the patient's needs. Outcomes/ Clinical /Fiscal/Resource Management : + Utilizes statistical analysis techniques to measure … more
- HCA Healthcare (Nashville, TN)
- …and evaluate changes in formulary strategy including exclusions, tier changes, and utilization management updates + Working knowledge of employee pharmacy ... member. + Meets member specific targets for contract performance, trend management , savings and strategic objectives. + Establishes productive, professional and… more