- Cardinal Health (Boise, ID)
- …data and insights through real-world clinical research. Research Operations and Clinical Specialty is responsible for providing quality , timely, granular and ... of electronic data capture tools, assessing and ensuring the quality of clinical data across diverse specialty...research to support projects + Reviews and audits chart review data before and after data validation to ensure… more
- Prime Therapeutics (Boise, ID)
- … clinical research and analytics that improve medical cost savings and provide clinical quality initiatives + Manages current clients in all Medical Pharmacy ... drives every decision we make. **Job Posting Title** Director, Specialty Clinical Solutions -RPH/PharmD required- REMOTE **Job Description Summary** Responsible for… more
- HealthEdge Software Inc (Boise, ID)
- …user experience, client needs and organizational and business priorities, while maintaining the clinical quality and standards of our product. Because you will ... or clinical improvement opportunities. + Lead the clinical review of existing clinical ...author corresponding surveys & alerts that leverage evidence-based guidelines, clinical best practices and key quality improvement… more
- Prime Therapeutics (Boise, ID)
- …fuels our passion and drives every decision we make. **Job Posting Title** Physician Clinical Reviewer - GI- REMOTE **Job Description Summary** Key member of the ... clinical determinations cannot be made by the Initial Clinical Reviewer . + Discusses determinations with requesting...as needed to discuss cases and problems. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- Evolent Health (Boise, ID)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management team. ... provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD… more
- Evolent Health (Boise, ID)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Physician Clinical Reviewer you will be a key member of the utilization management ... when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the… more
- Cardinal Health (Boise, ID)
- …of all program compliance activities, product training and adverse event/product quality complaint training. . Oversight of clinical training, coach, ... **_What Clinical Supervisor contributes to Cardinal Health_** Customer Service...to termination when applicable. . Continually monitor program adherence, quality , attendance, and address accordingly. . Report Corrective and… more
- CVS Health (Boise, ID)
- …enterprise and provides clinical oversight and mentorship for CVS Health clinical programs, PBM Clinical Quality activities, consultative support to ... when appropriate. - Medical Directors will participate in inter-rater review activities and other quality oversight processes... clinical oversight and mentorship for CVS Health clinical programs, PBM Clinical Quality … more
- CVS Health (Boise, ID)
- …system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. **This is ... responses to members and providers. In addition you will oversee utilization review / quality assurance, directing case management. In this role you'll provide… more
- Evolent Health (Boise, ID)
- …groups to provide exceptional support of timely and accurate delivery of high- quality Evolent clinical guidelines. Our team values collaboration, continuous ... and Legislative/Regulatory Guidelines + Maintain source of truth information related to clinical guidelines application for utilization review requests + Support… more
- CVS Health (Boise, ID)
- …system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. **This is ... and providers. You will lead all aspects of utilization review / quality assurance, directing case management. In this...directing case management. In this role you will provide clinical expertise and business direction in support of medical… more
- CVS Health (Boise, ID)
- …care system is more transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This is ... **As a Medical Director you will focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews.**… more
- Intermountain Health (Boise, ID)
- …services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management. **Job Specifics** + Pay Range ... other (SO). Assesses patient/member per CMS Condition of Participation (COP) or National Clinical Quality Association (NCQA) standards. Ensures a plan of care is… more
- Evolent Health (Boise, ID)
- …and external customers through positive interactions, and timely delivery of high- quality products. Our team values collaboration, continuous learning, and a ... decisions against criteria and policy, escalating questions to the physician reviewer , and creating letters that meet regulatory and Plain Language requirements.… more
- Prime Therapeutics (Boise, ID)
- …drives every decision we make. **Job Posting Title** Senior Director Operations - Clinical Review - Remote **Job Description** The Senior Director Operations is ... for strategic leadership and tactical development of a department within our Clinical Review Operations functional area. The Sr Director Operations drives… more
- Evolent Health (Boise, ID)
- …+ Responsible to assist with all types of audits including Interrater, Customer, Clinical quality , and/or confirmation of process changes. + Holds Field Medical ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance...Doing:** + Provides medical direction to the support services review process. Responsible for the quality of… more
- American Heart Association (Boise, ID)
- …and conduct data monitoring activities within registry tool. This position will continually review site and registry-wide data for quality , completeness, and ... or in a public health-related organization, clinical registries, patient registries, clinical studies or quality improvement programs + Experience and proven… more
- Prime Therapeutics (Boise, ID)
- …including documentation of all daily activities. + Performs related duties as requested. + Clinical and Quality oversight for this program is provided by the ... drug infusion services versus the hospital outpatient facility. Discusses financial and clinical considerations with members who are considering care at a higher… more
- Elevance Health (Meridian, ID)
- …analyze and process pre service and post service grievances and appeals requests related to clinical and non clinical services, quality of service and ... manner. + May also be responsible to provide review and analysis of complex pre service and post...appeals requests from customer and multiple products related to clinical and non clinical services, quality… more
- Trinity Health (Boise, ID)
- …Type:** Full time **Shift:** Day Shift **Description:** We are looking for a Clinical Research Coordinator to join our team in Boise in support of Oncology ... research! **POSITION PURPOSE:** As a Clinical Research Coordinator, you will work on-site to facilitate...guidelines and expectations that ensure compliance with research billing review practices. + Coordinates IRB submission of all proposed… more