- Legend Biotech USA, Inc. (Detroit, MI)
- …Affairs team. Direct education for healthcare professionals treating oncology patients on clinical data, adverse event management , and mechanism of action for ... between investigators and members of the Legend Biotech Medical Affairs and Clinical Development teams; Addressing AE management and education as… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …account managers, producers, and clients about pharmacy programs and benefits. + Provide clinical drug utilization management , formulary management , and ... serve pharmacy students and/or residents as a preceptor, introducing them to drug utilization management , care management activities, product review, and… more
- ERP International (Yuma, AZ)
- …algorithms, CM software, and databases for community resources. - Integrate CM and utilization management (UM) and integrating nursing case management with ... algorithms, CM software, databases for community resources, etc. + Integrate CM and utilization management (UM) and integrate nursing case management with… more
- CVS Health (Oklahoma City, OK)
- …a psychiatric or behavioral health setting required. + Strong knowledge of clinical practice guidelines and utilization management . **Required** ... heart, each and every day. **Position Summary: Behavioral Health Clinical Reviewer (LCSW, LCPC, RN)** Licensed clinical ...to coordinate, document, and communicate all aspects of our utilization and benefit management programs. You'll apply… more
- CVS Health (Columbus, OH)
- … skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable ... external constituents in the coordination and administration of the utilization /benefit management function **Required Qualifications** + Licensed independent… more
- CVS Health (Columbus, OH)
- …resolving clinical complaints and appeals by reviewing medical records and applying clinical guidelines for Utilization Management group. This RN must be ... high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our...3+ years Utilization Management or Utilization Review experience. + 3+ years clinical … more
- CVS Health (Austin, TX)
- …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 central time zones… more
- CVS Health (Austin, TX)
- …6:00 pm EST or 9:30am to 6:00pm EST with occasional weekend/holiday/evening rotation.** ** Utilization Management is a 24/7 operation and work schedules will ... it all with heart, each and every day. Medicare Clinical Predetermination Nurse **Must be willing and able to...or 9:30am to 6:00pm eastern with occasional weekend/holiday/evening rotation. Utilization Management is a 24/7 operation and… more
- CVS Health (Springfield, IL)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function - Gathers clinical information and ... + **M** anaged care experience + Discharge planning experience + Utilization Management experience **Education** ASN Required, BSN Preferred **Anticipated… more
- CVS Health (Phoenix, AZ)
- …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
- CVS Health (Springfield, IL)
- …and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of ... to work 8-5pm local time. **Preferred Qualifications** + Prior authorization utilization experience preferred + Outpatient Clinical experience + Knowledge… more
- CVS Health (Phoenix, AZ)
- …promote high-quality healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this ... role, you'll be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to...a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM… more
- CVS Health (Columbus, OH)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and ... it all with heart, each and every day. **Position Summary** + Utilizes clinical experience and skills in a collaborative process to assess, plan, implement,… more
- CVS Health (Springfield, IL)
- …time is spent at a desk and on the phone collecting and reviewing clinical information from providers. Utilization Management nurses use specific criteria ... paced environment NICU experience 3+ years **Preferred Qualifications** Previous Utilization Management experience Spine Experience **Education** Associates… more
- Vitalief (New Brunswick, NJ)
- …and achieve sustainable growth. The Role We are seeking a highly experienced Clinical Research Operational Management Consultant to lead a short-term ... and accelerate breakthroughs that improve patient care. We bring deep clinical research expertise together with practical, results-driven consulting to help… more
- CareFirst (Baltimore, MD)
- …**Experience:** 5 years experience in business development, operational technology support, Utilization Management (UM) operations, Clinical Product ... role will focus specifically on optimizing end-to-end business processes within Utilization Management . **ESSENTIAL FUNCTIONS:** + Provide deep subject matter… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Cross and Blue Shield of Minnesota Position Title: Principal Provider Performance Clinical Consultant Location: Hybrid | Eagan, Minnesota Career Area: Strategic ... and leading consultative conversations with provider groups about opportunities to improve clinical and cost/ utilization trend. * Responsible for developing and… more
- BD (Becton, Dickinson and Company) (San Jose, CA)
- …This position reports to the Regional Business Manager and supports the Specimen Management business unit. This role observes current clinical practice and ... responsibilities will include:** + Fosters a continually evolving partnership between Specimen Management and our valued customers in a Clinical Process advisory… more
- Molina Healthcare (Orlando, FL)
- …the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company's discount position ... analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and leading consultative conversations with provider groups about opportunities to improve clinical and cost/ utilization trend. * Responsible for developing and ... all lines of business. The role works in tandem with the Manager of Clinical Consultation, Pr Provider Performance Clinical Consultants, and the Medical Director… more
