- CenterWell (Frankfort, KY)
- …healthcare industry. The UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration ... works on semi-routine assignments. Shift Hours - 8a - 5 The UM Administration Coordinator - Phone Intake provides non-clinical support for the policies and… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …care, care coordination, health promotion, health education and coaching on wellness, disease prevention, and chronic care management . The nurse will assist ... education, orientation, competencies and providing quality improvement and outcomes utilization . Demonstrates leadership in delivering and improving holistic, specialty… more
- United Therapeutics (Frankfort, KY)
- …therapies that treat PAH, pulmonary hypertension associated with interstitial lung disease (PH-ILD) and neuroblastoma, a rare pediatric cancer. Our near-term ... to provide continuous education on UT products, pumps and disease states, ensuring that physicians, nurses and other healthcare...make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field… more
- Molina Healthcare (Louisville, KY)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment, disease management ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and...resource management . + Develops and implements a Utilization Management program and action plan, which… more
- Evolent (Frankfort, KY)
- …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- CenterWell (Louisville, KY)
- …providing medical guidance and expertise. + Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the ... Responsible for medical interpretation, reviews, and decisions as required for plan administration . + Monitor medical performance and provide guidance to ensure that… more
- CVS Health (Frankfort, KY)
- …Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible ... interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing… more
- Highmark Health (Frankfort, KY)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... participates as the physician member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Louisville/Jefferson County MSD (Louisville, KY)
- …centers, wellness seminars, health-risk screenings at the annual health fair and a disease management program offered through the group medical plan, are just ... Diversity Advisory Council as directed by the Manager. Prepares data reports for management information, compliance and utilization . Coordinates a variety of MSD… more
- Fujifilm (Frankfort, KY)
- …Biomarkers sales through that community. As assigned interface with Senior Management teams from major IVD manufacturers. Maintain a comprehensive understanding of ... **Job Description** **Duties and responsibilities** + Must be able to demonstrate disease state competency and articulate a strong value proposition for the… more