• Novo Nordisk Inc. (San Francisco, CA)
    About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse and collaborative groups within the ... and developing and implementing regulatory strategies with the FDA to providing medical education and collecting data to support efficacy and new product… more
    HireLifeScience (06/12/25)
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  • Daiichi Sankyo, Inc. (Bernards, NJ)
    …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... cross-functional, integrated study plan and create initial study budget. Review study feasibility assessments provided by the CRO(s), lead...risk related plans and ensure study team adherence and utilization . Be aware of and be able to predict… more
    HireLifeScience (03/28/25)
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  • Novo Nordisk Inc. (San Diego, CA)
    …proactive collaboration with internal teams such as Sales, Marketing, Market Access, Medical , Legal, and Compliance, contributing to NNI's CM Sales organization and ... and adapting to business priorities Educate HCPs to increase product utilization , optimize treatment, and align with evidence-based medicine and guidelines, while… more
    HireLifeScience (06/10/25)
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  • Merck & Co. (Durham, NC)
    …culture by reducing waste and constantly driving continuous improvement. -Responsible to review and approve compliance documents, as per procedures or need.Supply - ... - Responsible for creating and sustaining a highly engaged workforce through utilization of our Company Leadership Behaviors and Inclusion.- Provide coaching on… more
    HireLifeScience (06/13/25)
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  • Novo Nordisk Inc. (Boston, MA)
    …proactive collaboration with internal teams such as Sales, Marketing, Market Access, Medical , Legal, and Compliance, contributing to NNI's CM Sales organization and ... and adapting to business priorities Educate HCPs to increase product utilization , optimize treatment, and align with evidence-based medicine and guidelines, while… more
    HireLifeScience (05/29/25)
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  • Merck & Co. (Durham, NC)
    …culture by reducing waste and constantly driving continuous improvement-- Review and approve compliance documents, as per procedures or need.Supply/Support ... Management - Creating and sustaining a highly engaged workforce through the utilization of Company Leadership Behaviors and Inclusion - Provide coaching on… more
    HireLifeScience (06/04/25)
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  • Novo Nordisk Inc. (Plainsboro, NJ)
    …(Pricing, Contracting, Operations and Reimbursement), HEOR, Marketing, Commercial Sales, Medical Affairs, and Legal & Compliance. External relationships include ... their placement in the treatment continuum as well as appropriate utilization and treatment guidelines Proactively leverages detailed knowledge of all applicable… more
    HireLifeScience (06/14/25)
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  • Novo Nordisk Inc. (Boston, MA)
    …and Professional Associations. Internally, this position will collaborate with STARS Medical Liaisons, and STARS Account Managers. Essential Functions Attention to ... collateral development Achieve or exceed assigned sales objectives through effective utilization of all available resources, strategies and tactics Collaborates with… more
    HireLifeScience (06/12/25)
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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Manhattan Psychiatric Center, P26306 Occupational Category Health ... Code 10035 Duties Description Manhattan Psychiatric Center is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and… more
    New York State Civil Service (06/12/25)
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  • Utilization Review Nurse - Emergency…

    Houston Methodist (The Woodlands, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... medical record review for medical ...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
    Houston Methodist (06/06/25)
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  • BH Utilization Review Clinician

    Commonwealth Care Alliance (Boston, MA)
    …in behavioral health managed care preferred + Experience in behavioral health utilization review or medical necessity evaluation preferred **Required ... Mgmt **Position Summary:** The Sr Clinician, Behavioral Health Utilization Review will review behavioral...review behavioral health and substance use admissions for medical necessity and appropriate levels of care and assist… more
    Commonwealth Care Alliance (05/21/25)
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  • Physical Therapy Utilization Review

    Sedgwick (Phoenix, AZ)
    …Work(R) Fortune Best Workplaces in Financial Services & Insurance Physical Therapy Utilization Review Advisor **For client coverage; prefer someone in Mountain ... updated with relevant industry regulations, guidelines, and best practices related to utilization review and maintains compliance with applicable laws and… more
    Sedgwick (04/24/25)
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  • Manager Utilization Management Operations…

    Tufts Medicine (Burlington, MA)
    …**Job Overview** The position provides day to day support and oversight to Utilization Review departments and UM vendor management. The UM Operations Manager ... is responsible for compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning including implementation and annual … more
    Tufts Medicine (06/01/25)
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  • Manager, Utilization Management

    Commonwealth Care Alliance (Boston, MA)
    …Knowledge, Skills & Abilities (must have): * Expertise in managing utilization review processes including prior authorization, concurrent and retrospective ... is responsible for overseeing and managing the daily operation of the Utilization Management Review Nurse and Specialist staff responsible for conducting… more
    Commonwealth Care Alliance (05/21/25)
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  • Interim RN Utilization Review

    Ascension Health (Baltimore, MD)
    **Details** + **Department:** Ascension Travel Program & Interim Leadership + **Schedule:** Full-time + **Hospital:** St. Agnes + **Location:** Baltimore, MD * Rates ... Please consult with your Recruiter to learn more. Will serve as an Interim Travel Nursing leader with the potential to serve various Ascension hospitals. For more… more
    Ascension Health (04/24/25)
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  • Nurse Utilization Management Reviewer

    Commonwealth Care Alliance (Boston, MA)
    …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager...**Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior authorization in a variety… more
    Commonwealth Care Alliance (05/23/25)
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  • Utilization Management Coordinator

    Humana (Frankfort, KY)
    …Prior member service or customer service, telephone experience + Experience with Utilization Review and/or Prior Authorization. preferably within a managed care ... health first** The UM Administration Coordinator contributes to administration of utilization management for Humana's KY Medicaid plan. The UM Administration… more
    Humana (06/11/25)
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  • Utilization Management Nurse

    Katmai (Fort Carson, CO)
    …need for inpatient/outpatient precertification. **ESSENTIAL DUTIES & RESPONSIBILITIES** + Review precertification requests for medical necessity, referring to ... Medical Director those that require additional expertise. + Review clinical information for concurrent reviews. + As part...Minimum of two (2) years of prior experience in Utilization Management. + Must possess a current, active, full,… more
    Katmai (04/20/25)
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  • Utilization & Disease Management…

    CenterWell (Topeka, KS)
    …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... Administration Coordinator - Phone Intake contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and… more
    CenterWell (06/10/25)
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  • Utilization Management Services Rep…

    Excellus BlueCross BlueShield (Rochester, NY)
    …you to apply! Job Description: Summary: This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. ... fax for inpatient and outpatient procedures, behavioral health, and durable medical equipment. Essential Accountabilities: Level I + Facilitates inbound and outbound… more
    Excellus BlueCross BlueShield (05/29/25)
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