- Novo Nordisk Inc. (Tacoma, WA)
- …elements in the market to identify and leverage business opportunities Analyze impact of managed care in the territory and its effect on prescribing decisions, ... resources to expand the breadth and depth of appropriate utilization Novo Nordisks products, consistent with label and company...align to audience needs Leverage understanding of impact of managed care in the territory and how… more
- University Medical Center of El Paso (El Paso, TX)
- …Experience: Work Experience: Two years of experience with clinical documentation, chart reviewing, utilization review , managed care , and/or claims ... denials and appeals processing required. License/Registration/Certification: Certified Clinical Documentation Specialist preferred. Education and Training: Bachelor's degree in related field required. more
- Novo Nordisk Inc. (Chicago, IL)
- …and medical field support to Medical, Sales and Marketing, as well as Managed Care and Government by using academic/professional credentials and scientific ... two years' experience in a health related system, pharmaceutical company, or managed care environment required Relevant clinical and/or therapeutic experience… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …position is part of the business assurance function for Commercial, Part D, & Managed Care contracts. This role is responsible for ensuring the validation of ... include partnership with Novo Nordisk Global Service Center formulary validation team, managed care customers, field sales personnel, and system vendors.… more
- Novo Nordisk Inc. (Chicago, IL)
- …Medical Liaisons and their contacts with academic institutions, integrated delivery networks, managed care organizations and HMOs, as needed based on territory ... most diverse and collaborative groups within the organization. From health- care -provider interactions and developing and implementing regulatory strategies with the… more
- Daiichi Sankyo, Inc. (Basking Ridge, NJ)
- …creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging ... develop a cross-functional, integrated study plan and create initial study budget. Review study feasibility assessments provided by the CRO(s), lead the CRO… more
- The University of Vermont Health Network (Plattsburgh, NY)
- GENERAL SUMMARY:The Utilization Review RN monitors, collects and analyzes data and evaluates variances of resource utilization , complications and overall ... based on benchmarked criteria or established practices. The Utilization Review RN in utilizing these skills...and The Joint Commission regulations is preferred.10. Knowledgeable in managed care processes is preferred. Computer experience… more
- Lake Behavioral Hospital (Waukegan, IL)
- Lake Behavioral Hospital is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Waukegan, Illinois.Job Description & RequirementsSpecialty: ... Ongoing40 hours per weekShift: 8 hours, daysEmployment Type: StaffOutpatient Utilization Review CoordinatorJob LocationLake Behavioral Hospital - Waukegan,… more
- Cambia Health Solutions, Inc (Portland, OR)
- …care setting.Demonstrated success in managing professional relationships in a managed care system, medical group, hospital, or related organizations.Excellent ... implementing clinical strategies with respect to formulary management, drug utilization management, medication therapy management programs, quality initiatives, gaps… more
- Integrated Resources, Inc (New York, NY)
- …. Working in the field for a Certified Home Health Agency (CHHA), Licensed Home Care Service Agency (LHCSA), or Managed Long-Term Care (MLTC) . Conducting ... like the UAS such as OASIS. . Providing primary care to homebound persons . Care management...private duty nursing) Case management that is limited to utilization reviews for a health plan or a combination… more
- Jazz Pharmaceuticals (Houston, TX)
- …risks, cost impacts of managing patient careExternal customers - current reimbursement landscape/ managed care , payer issues and trends, and other factors which ... the resources required to execute the strategic account plan effectivelyContinuously review and adjust the strategic account plan based on activities, feedback,… more
- Universal Health Services (Colorado Springs, CO)
- …an accredited college or university with a current Colorado RN license. Experience in utilization review , managed care , or determining appropriateness ... position is responsible for providing initial, ongoing, and systematic utilization review on all patients assigned by...with work hours to accommodate work volumes. Knowledge of utilization management and managed care … more
- Martin's Point Health Care (Portland, ME)
- …preferred, Master's in nursing or related field preferred + 5 years of utilization review experience in a managed care setting including experience in a ... been certified as a "Great Place to Work" since 2015. Position Summary The Manager Utilization Review is responsible for oversight of utilization review … more
- Catholic Health (Lockport, NY)
- …+ Two years medical surgical nursing and/or job related experience + Preferred prior insurance / managed care / utilization review experience in the role of ... and Holiday Rotation Hours: 8:00a-4:00p, 9:00a-5:00p, 10:00a-6:00p, 11:00a-7:00p Summary: The RN Care Manager, Utilization Review / Transitions of Care… more
- SUNY Upstate Medical University (Syracuse, NY)
- …agencies, and other health care related entities. Preferred Qualifications: Utilization Review / Managed Care /Quality Assurance experience. Experience ... Job Summary: The Utilization Review /Quality Assurance Sr. Coordinator will...Coordinator will be responsible for providing clinical information to managed care companies as requested for hospitalized… more
- CVS Health (Harrisburg, PA)
- …- Holiday rotation required Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - Strong ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Harrisburg, PA)
- …(PowerPoint, Word, Excel, Outlook) Preferred Qualifications: - 1+ years' experience Utilization Review experience - 1+ years' experience Managed Care - ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Frankfort, KY)
- …outside of the standard schedule based on business needs Preferred Qualifications: + Managed care / utilization review experience preferred + Experience ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- CVS Health (Harrisburg, PA)
- …position Preferred Qualifications Knowledge of mental health and substance abuse disorders. Managed care / utilization review experience Crisis ... of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at… more
- Lancaster General Health (Lancaster, PA)
- …Board of Nursing. + Bachelor's degree in Nursing (BSN). + Knowledge of utilization review or managed care . + Care management experience in a ... care across the continuum (inpatient/outpatient/community) to assure appropriate utilization of clinical and community resources. + Oversees and guides the… more
