- Novo Nordisk Inc. (Oklahoma City, OK)
- …of patients with obesity to maximize sales within an assigned territory. The Obesity Care Specialist (OCS) must achieve sales goals by implementing marketing and ... to identify and leverage business opportunities Analyze impact of managed care in the territory and its...for the job titles are the following : Obesity Care Specialist I - $65,850 to $115,240… more
- Eisai, Inc (Nutley, NJ)
- …provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking through ... mild cognitive impairment due to Alzheimer's disease (AD) or mild AD. TheNeurology Account Specialist (NAS) will be part of a diverse team of sales professionals who… more
- Hawaii Pacific Health (Honolulu, HI)
- …and training, as well as internal peer equity. **Position** Specialist , Managed Care - Utilization Mgmt **Category** Administrative **Employment Type** ... As the Specialist , you will be responsible for providing comprehensive managed care information related to Hawai'i Pacific Health contracted health plans,… more
- LA Care Health Plan (Los Angeles, CA)
- … Utilization Management/Case Management experience in a hospital or HMO setting. Preferred: Managed Care experience performing UM and CM at a medical group or ... Utilization Management Nurse Specialist LVN II...At least 4 years of experience in a patient care setting and/or combination in utilization management,… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Nurse Specialist RN II Job...experience in a hospital or HMO setting . Preferred: Managed Care experience performing UM and CM at ... net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II will...of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge… more
- FLACRA (Clifton Springs, NY)
- …managerial experience Job Requirements: Duties: + Understands and works closely with all Managed Care insurance providers and their policies and procedures on ... UTILIZATION MANAGEMENT SPECIALIST Finger Lakes Addiction...in pursuing advocacy as necessary. + Works collaboratively with care team, client, and family to ensure the development… more
- Hackensack Meridian Health (Hackensack, NJ)
- …& levels of appeal iv. Root cause analysis & trends v. Participation in Managed Care Contracting & distribution of contract terms where appropriate 7. ... **Overview** The Senior Utilization Review Physician Specialist collaborates with...Management and Organizational Strategy a. Development & implementation of Utilization Management strategies to assure appropriate health care… more
- LA Care Health Plan (Los Angeles, CA)
- …internal LA Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and Support (MLTSS), Social Services, ... Enhanced Care Management Clinical Specialist II Job...care professionals in a hospital, medical group or managed care setting, such as a health… more
- University of Washington (Seattle, WA)
- …. RN2, Utilization Management ... position will have partial/variable involvement with Harborview's Emergency Department. The Utilization Management Specialist RN2 is responsible for the ongoing… more
- LA Care Health Plan (Los Angeles, CA)
- Care Management Specialist II Job Category:...care professionals in a hospital, medical group or managed care setting, such as a health ... to support the safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Medical/Provider Groups, ancillary vendors, industry-wide organizations (ie Department of Managed Health Care , Alameda County Health department, California… more
- Universal Health Services (Bloomington, IN)
- …all patients. Oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payers. Assures that ... Responsibilities The Utilization Management Specialist is responsible for executing the UM function, which includes the implementation of case management… more
- Novo Nordisk (Oklahoma City, OK)
- …of patients with obesity to maximize sales within an assigned territory. The Obesity Care Specialist (OCS) must achieve sales goals by implementing marketing and ... identify and leverage business opportunities + Analyze impact of managed care in the territory and its...the job titles are the following : * Obesity Care Specialist I - $65,850 to $115,240… more
- Novo Nordisk (Princeton, NJ)
- …with diabetes to maximize sales within an assigned territory. The Endocrinology Diabetes Care Specialist (EDCS) must achieve sales goals by utilizing a ... would benefit in order to ensure early trial and utilization + Generate advocacy for Novo Nordisk products and...identify and leverage business opportunities + Analyze impact of managed care in the territory and its… more
- Houston Methodist (Houston, TX)
- …the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, ... At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of optimal… more
- LA Care Health Plan (Los Angeles, CA)
- …of benefits data, identifying discrepancies, and resolving issues to optimize benefit utilization and minimize costs. The COB Validation Specialist collaborates ... Coordination of Benefits Validation Specialist II Job Category: Administrative, HR, Business Professionals...Customer Service. Preferred: 3 years of office experience in Managed Health Care . Skills Required: Solid understanding… more
- Organon & Co. (Plymouth Meeting, PA)
- … while meeting the needs of customers. + Understanding of the local managed care and reimbursement environment relevant to various customer segments and ... their current practice structure, business model, and key influencers (ex: Managed Care Organization/payers, Management Service Organizations (MSOs), employers,… more
- Sharp HealthCare (San Diego, CA)
- …Qualifications** + Experience as a case manager or discharge planner interacting with managed care payers. **Essential Functions** + Act as a resource ... business practices. **What You Will Do** To provide comprehensive utilization management and coordination of care for...and current standards of clinical practice. + Knowledge of managed care , Health Plan contracts, and benefits.… more
- UTMB Health (Huntsville, TX)
- …States** Allied Health UTMB Health Requisition # 2304621 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... Ambulatory Care Pharmacy Clinical Practice Specialist -...Formulary design. + Development of clinical practice guidelines. + Utilization review and monitoring of prescribed trends + Education… more
- ManpowerGroup (Rancho Cucamonga, CA)
- …+ Experience as a data entry specialist preferably in an HMO or Managed Care setting. + Utilization Management experience preferred. + Minimum of ... codes + Knowledge of utilization management in a health care delivery setting preferred. + Managed Care or physician office a must ManpowerGroup is… more
