- Evolent Health (Springfield, IL)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... , you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- CVS Health (Springfield, IL)
- … in support of Key Clients as assigned.The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds ... programs and commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy revisions/reviews.- Directors… more
- Evolent Health (Springfield, IL)
- …Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Springfield Clinic (Springfield, IL)
- …physician assistants in their professional development, ensuring all regulatory, accreditation and clinical standards are met, including identifying, measuring and ... issues related to Advanced Practice Professionals - Serves on the Quality Management , Credentialing and TouchWorks Advisory Board (other committees as needed such as… more