- Centene Corporation (Richmond, VA)
- …workflows, enhancing data accuracy, and driving efficiency to support timely and compliant claims outcomes. + Leads utilization management team on ... + Partner closely with claims and clinical and non-clinical Utilization Management (UM) team members to align processes and improve end-to-end handling of… more
- Humana (Richmond, VA)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Richmond, VA)
- …reports to Lead depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Richmond, VA)
- …LMSWs, LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be ... the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as...prior authorization requests and/or relevant health care experience in claims or appeal & grievances is required. + Ability… more
- Otsuka America Pharmaceutical Inc. (Richmond, VA)
- **Job Summary** The Director , Nephrology & Immunology Publications Lead is responsible for leading the planning, development, and execution of the global medical ... within the Nephrology & Immunology Medical Communications team, the Director partners closely with cross-functional stakeholders, including Clinical Development,… more
- Otsuka America Pharmaceutical Inc. (Richmond, VA)
- The Associate Director , Rare Disease Strategic Planning Lead will support the assets of varying lifecycle stages in the Rare Disease portfolio. This role is crucial ... medical affairs processes are in place. This position reports directly into the Director , Strategic Planning Lead, who in turn reports into the Medical Excellence &… more
- Otsuka America Pharmaceutical Inc. (Richmond, VA)
- …promotional execution, and omnichannel engagement to drive awareness, adoption, and utilization among HCPs. The Director will work cross-functionally with ... **Position Summary** The Director , HCP Marketing Lead guides the healthcare provider (HCP) engagement strategy for Centanafadine, a novel launch product for ADHD.… more
- Humana (Richmond, VA)
- …corporate communications to be shared with senior leadership. + Supports trend management by conducting analysis of drug spend, utilization , and/or approval ... Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical… more