- Trinity Health (Des Moines, IA)
- …time **Shift:** Day Shift **Description:** This position is **onsite** . The purpose of the Non - Clinical Risk Management Specialist is to assist and ... support the non - clinical risk management functions across the MercyOne Central Division _(_ _work_ _ing_ _collaboratively with the non - clinical … more
- Sharecare (Des Moines, IA)
- …the participants and their Primary Care Provider according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting the goals and objectives… more
- Otsuka America Pharmaceutical Inc. (Des Moines, IA)
- …Ensure continuous inspection readiness across all clinical trial sites, clinical and Pharmacovigilance (PV) operations. + **Audit Management :** Oversee the ... applicable regulations and guidelines that ensure sustained GCP/QSR compliance. + **Vendor Management :** Leads and develops systems for Clinical vendor … more
- WelbeHealth (Des Moines, IA)
- …into analytics. + Serve as a subject matter expert for business rules and logic ( clinical and non - clinical ) to convert information into operational and ... problems and varied healthcare datasets and domains (eg, enrollment, benefits, claims, clinical , risk , healthcare financials etc.) **Benefits of Working at… more
- Evolent (Des Moines, IA)
- …programs that include improvements to clinical effectiveness of utilization management (UM) and risk -based models.** + Process improvement and enhancement ... - Cardiovascular Medicine** to play a critical role in **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This… more
- Highmark Health (Des Moines, IA)
- …for the Medicare Advantage (MA) market. The incumbent will manage a team of clinical and non - clinical professionals, driving the design and launch of ... Developing and executing the organization's MA pharmacy strategy, including formulary management , benefit design, and program development. This requires a deep… more
- ASM Research, An Accenture Federal Services Company (Des Moines, IA)
- Provides assistance, services, resources, referrals, and consultation on various Non -Medical Counseling (NMC)/Employee Assistance Programs (EAP) and work/life issues ... members and their families. Demonstrates expertise in handling and managing high- risk calls with professionalism and in accordance with established protocols.… more
- Sedgwick (Des Moines, IA)
- …partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work ... environment, who are driven to deliver great work. + Apply your medical/ clinical or rehabilitation knowledge and experience to assist in the management… more
- Fujifilm (Des Moines, IA)
- …Manage specific assigned geographic areas and successfully drive the FUJIFILM HCC Risk Biomarkers sales through that community. As assigned interface with Senior ... Management teams from major IVD manufacturers. Maintain a comprehensive...of IVD reagent systems, distribution modalities, as well as clinical performance and utility of assays. **Company Overview** At… more
- ASM Research, An Accenture Federal Services Company (Des Moines, IA)
- …+ Participates in staff meetings and clinical conferences + Supports quality and risk management to meet call center target metrics + Ensures complete and ... provide assistance, services, resources, referrals, and consultation on various Non -Medical Counseling (NMC)/Employee Assistance Programs (EAP) and work/life issues… more
- Evolent (Des Moines, IA)
- …driving analysis and support for Evolent's fast growth and innovative risk -based Performance Suite business. **Collaboration Opportunities:** This person will work ... stakeholders for vetting, including Performance Suite, Product, Claim Ops and Clinical teams. + Develop standardized processes, templates, and collateral for key… more
- Sharecare (Des Moines, IA)
- …3rd parties for care management and second opinion. + Referring members to Clinical Advocates (Nurse) for conditions that require clinical care and case ... new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and… more
- Eliassen Group (Des Moines, IA)
- …of companies reach further and achieve more with their technology solutions, financial, risk & compliance, and advisory solutions, and clinical solutions. With ... Technology Lead will also effectively communicating with both technical and non -technical stakeholders. The Technology Lead will have strong leadership skills, with… more
- Sedgwick (Des Moines, IA)
- …client requirements for a qualifying condition. + Makes claim determinations to approve non -complex ADA claims or makes a recommendation to team lead to deny claims ... initial employee interview per process guidelines. + Utilizes the appropriate clinical and vocational resources in case assessment (ie duration guidelines, in-house… more
- Evolent (Des Moines, IA)
- …arrangements + Incorporate business expectations for the financial impacts of clinical integration, population management processes, provider contracts, and ... on the organization and patient health. This role supports both medical cost management activities and business development efforts. **What You Will Be Doing:** +… more
- Eliassen Group (Des Moines, IA)
- …of companies reach further and achieve more with their technology solutions, financial, risk & compliance, and advisory solutions, and clinical solutions. With ... communicate technical solutions and strategies to both technical and non -technical stakeholders **Experience Requirements:** + Proven experience as a Cloud… more