- CVS Health (Nashville, TN)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Nashville, TN)
- …+ Human Resource and/or Supervisory experience. + Case management , Utilization Review, or Utilization Management background preferred. **Education** ... Friday, 11:00 am to 8:00 pm Eastern Time.** The Consultant provides management consultation to corporate clients...clinical assessments and triage into care. Performs case management across scope of all types of management… more
- Highmark Health (Nashville, TN)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- Elevance Health (Nashville, TN)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May...an entire clinical program and/or independently performs clinical reviews. + Typically has program management … more
- HCA Healthcare (Nashville, TN)
- …and evaluate changes in formulary strategy including exclusions, tier changes, and utilization management updates + Working knowledge of employee pharmacy ... member. + Meets member specific targets for contract performance, trend management , savings and strategic objectives. + Establishes productive, professional and… more