- Carlsbad Tech (Monument, OR)
- Chief Medical Officer CMO job at Clinical Management Consultants. Monument, OR. A fantastic career opportunity for Chief Medical Officer CMO is now available ... will be responsible to design effective clinical practice patterns and clinical protocols to decrease inappropriate utilization and enhance quality outcomes… more
- CareOregon, Inc. (Portland, OR)
- …Implement and oversee effective systems to ensure access, program integrity, quality of clinical care, utilization management , compliance with OARs and other ... various departmental staff and regional partners to design and implement clinical initiatives that further quality, access, equity and/or cost and utilization… more
- Humana Inc (Salem, OR)
- …Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or clinical group practice management Utilization management ... put health first The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D...with prior experience participating in teams focusing on quality management , utilization management , or similar… more
- Boston Scientific Gruppe (Portland, OR)
- …nurture relationships with the referring physicians, implanting account, implanter, nursing staff and coordinators. Business Management Monitors region sales ... preparing reports, summaries, analysis, and documentation on all aspects of region management . Assists sales support/marketing staff members in activities such… more
- Humana (Salem, OR)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- CenterWell (Lake Oswego, OR)
- …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
- Highmark Health (Salem, OR)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... Utilize robust, data-driven insights from complex healthcare datasets (eg, claims, clinical , utilization , pharmaceutical) to inform policy development, identify… more
- Fresenius Medical Center (St. Helens, OR)
- …courses and that licensures/certifications are current. + Provides support for all clinical staff members at regular intervals and encourages professional ... eligibility for treatment. + Reports changes in patient status regarding any clinical , insurance, or travel and transportation issues. STAFF : + Participates… more
- Humana (Salem, OR)
- …corporate communications to be shared with senior leadership. + Supports trend management by conducting analysis of drug spend, utilization , and/or approval ... communicating with staff in different positions and all levels of management positions + Manages the Humana Michigan FIDE-SNP health plan relationship with our… more
- Abbott (Portland, OR)
- …medicines. Our 114,000 colleagues serve people in more than 160 countries. ** Clinical Associate** **About Abbott** Abbott is a global healthcare leader, creating ... from physicians, health care professionals, patients, and field sales staff , involving EP products. Performs work that involves a...monitors performance and reports status to manager. As a Clinical Associate on the US Abbott EP team, you… more
- Evolent (Salem, OR)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse… more
- Prime Therapeutics (Salem, OR)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... visa or residency sponsorship **Additional Qualifications** + 3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a… more
- Evolent (Salem, OR)
- … Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Highmark Health (Salem, OR)
- …per week (Tuesday-Thursday).** This role supports the full application product lifecycle for ** clinical and utilization management software** , with a ... and technical teams. They function as a pivotal bridge, translating high-level ** clinical and utilization management software** business needs into… more
- Evolent (Salem, OR)
- …Cardiologist)** Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical ... appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and clinical staff to address complex cases and… more
- Parexel (Salem, OR)
- …Data Management Lead to join our team. If you have a passion for clinical research, strong project management skills, and a knack for data management , ... Science, OR equivalent industry experience. + 7+ years experience in pharmaceutical/biotech clinical data management / Biometrics ( clinical trial data… more
- Evolent (Salem, OR)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Evolent (Salem, OR)
- …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 ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Evolent (Salem, OR)
- …As a Field Medical Director, MSK Surgery you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. Collaboration Opportunities: + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Evolent (Salem, OR)
- …Doing:** As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** . Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
