- CVS Health (Nashville, TN)
- … clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Nashville, TN)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST/CST zones… more
- Highmark Health (Nashville, TN)
- …needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, ... while also being capable of developing technical solutions. The consultant will act as a senior resource within the...the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The… more
- Oracle (Nashville, TN)
- …Vitals Collection (MVC), and Infusion Suite. As an Integrated Technologies Consultant II, you will be responsible for providing consulting implementation services ... These services include the integrated technology deployments of hardware, software, and clinical workflow consulting. As a member of the CareAware Device Integration… more
- Deloitte (Nashville, TN)
- Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk ... for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education tools as… 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