- Novo Nordisk Inc. (Pittsburgh, PA)
- …including budget expenditures as directed Records all activities within a customer response management system (eg VEEVA) and all expenses within Concur in ... policies, legal, regulatory, and compliance requirements Ensures effective administrative management of regional business as well as operational budgets Maintains… more
- Novo Nordisk Inc. (Minneapolis, MN)
- …to maximize NNI presence in retail pharmacies, pharmacy societies and certain health systems within the region, focusing on opportunities that will drive field sales ... pharmacy staff within retail pharmacies, pharmacy societies and health systems within a sales region who are not typically...execution of local market pharmacy plans Ensures optimal resource utilization and ROI for key strategies aligned with the… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …effectuating all business assurance initiatives including but not limited to utilization management controls, 340B compliance, and contract compliance. ... Provides analysis support around commercial rebate exclusions, formulary compliance, and utilization management controls and reports out to internal leadership… more
- Merck & Co. (Ames, IA)
- …orders based on optimal resource allocation, availability, and constraint management .Place production orders for production departments as required by forecast ... materials due to new product development.Setup & maintain material master system planning parameters.Supply ChainManage, level load and report capacity … more
- Merck & Co. (Durham, NC)
- …finances, labor, employee, environment and safetyTactical and strategic Shift(s) management , including collaboration with indirect staff;Promote the behaviors and ... culture by reducing waste and constantly driving continuous improvement. -Responsible to review and approve compliance documents, as per procedures or need.Supply -… more
- The University of Vermont Health Network (Plattsburgh, NY)
- …Department at Champlain Valley Physicians Hospital (CVPH) in Plattsburgh, NY.GENERAL SUMMARY:The Utilization Review RN monitors, collects and analyzes data and ... overall quality of care based on benchmarked criteria or established practices. The Utilization Review RN in utilizing these skills assists the Medical Center… more
- RestoraCare Staffing (Houston, TX)
- …Health Clinic (FQHC), skilled nursing facility, or wound clinic). Experience in utilization management , case management , discharge planning or other ... management and PC skills Current working knowledge of discharge planning, utilization management , case management , performance improvement, disease or… more
- Marion County (Salem, OR)
- …and objectives of the programs, to ensure high-quality service delivery.Develop performance management systems and set metric benchmarks to ensure accountability ... opportunities to identify existing strengths and gaps in existing service delivery system .Budget, Contract and Grant Management Provide expertise, oversight and… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …delegating/coordinating staff assignments and promoting staff development.* Responsible for the utilization and continued review of patient care protocols, ... disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our network of clinical… more
- Adventist Health (Portland, OR)
- …assisting in collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, ... Bachelor's Degree in Nursing (BSN): Preferred Experience in a care management role: Preferred Licenses/Certifications: Registered Nurse (RN) licensure in the state… more
- Guthrie (Sayre, PA)
- Position Summary: The Utilization Management (UM) Reviewer , in collaboration with other internal and external offices, payors, and providers and staff, is ... responsible for the coordinates Utilization Management (UM) processes and requirements for...prior authorization/certification for reimbursement of patient care services. The Utilization Reviewer : * Secures authorization as appropriate… more
- Sharp HealthCare (San Diego, CA)
- …time for routine, urgent and expedited referrals as outlined in SCMG's Utilization Management Plan.Decisions will be communicated to the appropriate persons ... + Knowledge of medical terminology, healthcare finances, alternative care options, utilization management , health plan criteria, established criteria such as… more
- Universal Health Services (Memphis, TN)
- …and advocates for patient length of stay and level of care. Oversees utilization review activities with other departments to ensure reimbursement for services ... Responsibilities Lakeside Behavioral Health System provides an excellent opportunity for those seeking...treatment team member or 5-7 years of experience in utilization management for both mental health and… more
- Prime Healthcare (Reno, NV)
- …(https://careers-primehealthcare.icims.com/jobs/159060/case-manager-rn-union 10hr smrmc- utilization - mgmt /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... orthopedic services, and an award-winning Cardiology program and more. The health system , a member of Prime Healthcare, also operates a fully-integrated Medical… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …safe discharge coverage for all hospital units. + Participates in utilization management initiatives/opportunities for improvement through departmental committee ... Florida. + 3 years minimum experience in discharge planning, utilization management , or case management ....with electronic medical records, and/or discharge planning and case management systems . + Able to maintain confidentiality… more
- Sharp HealthCare (San Diego, CA)
- …is appropriate for the referral request being reviewed.Document in the referral management system , according to SCMG operational processes, actions taken on ... the appropriateness of service/care.Attach corresponding documents to the referral within the referral management system in OnBase, the document management … more
- Dignity Health (Northridge, CA)
- …400 care centers. Visit dignityhealth.org/northridgehospital for more information. The RN Utilization Management Coordinator (UMC) is responsible for assessing ... and in compliance of the Behavioral Health Dignity Health Utilization Review Policy. + The UMC will...+ Current CA Registered Nurse (RN) license + Prior Utilization Management experience in a clinical or… more
- Prime Therapeutics (Columbus, OH)
- …- GI- REMOTE **Job Description Summary** Key member of the utilization management team, and provides timely medical review of service requests that do ... VP, Medical Affairs in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a… more
- Evolent Health (Columbus, OH)
- …Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + On a ... 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
- Trinity Health (Livonia, MI)
- …standards and deadlines. Data components will be obtained through the effective utilization of the hospital medical record system . + Demonstrates applicability ... the Information Systems Departments whose support is necessary for the management and success of the program. + Contacts patients and/or families via telephone… more
