- CVS Health (Richmond, VA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Richmond, VA)
- …And we do it all with heart, each and every day. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% remote. As a ... Utilization Nurse Consultant , you will utilize clinical skills to...to coordinate, document and communicate all aspects of the utilization /benefit management program and our plan sponsor(s).… more
- Guidehouse (Arlington, VA)
- …efficiency, quality, and reliability. Areas of expertise include care and utilization management , throughput, post-acute care and readmissions, pharmacy and ... and operational improvement across business and purchased services, supply cost, and clinical supply utilization at client provider organizations. Our team of… more
- Guidehouse (Arlington, VA)
- …efficiency, quality, and reliability. Areas of expertise include care and utilization management , throughput, post-acute care and readmissions, pharmacy and ... and operational improvement across business and purchased services, supply cost, and clinical supply utilization at client provider organizations. Our team of… more
- CVS Health (Richmond, VA)
- …+ Human Resource and/or Supervisory experience. + Case management , Utilization Review, or Utilization Management background preferred. **Education** ... Friday, 11:00 am to 8:00 pm Eastern Time.** The Consultant provides management consultation to corporate clients...clinical assessments and triage into care. Performs case management across scope of all types of management… more
- Highmark Health (Richmond, VA)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- Elevance Health (Richmond, VA)
- …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
- Elevance Health (VA)
- …clinical reviews. The Medical Director typically has program management responsibilities including clinical policy development, program ... programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor...discuss review determinations. + Serves as a resource and consultant for other areas of the company. + May… more