- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Underwriter - REMOTE **Job Description** The Underwriter is responsible for assisting in the development ... develop pricing in response to moderate to complex RFP's + Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing… more
- Prime Therapeutics (Columbus, OH)
- …make. **Job Posting Title** Clinical Account Manager - Georgia PDL - Remote in Georgia **Job Description** Innovative business clinician accountable for building and ... fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for additional… more
- Prime Therapeutics (Columbus, OH)
- …decision we make. **Job Posting Title** Sr. Director Actuarial Forecasting - REMOTE **Job Description** The Senior Director of Actuarial Forecasting leads a team ... functional leadership to develop and maintain projected trend assumptions related to utilization , unit cost, and gross/net rebate assumptions + Owns the annual… more
- Prime Therapeutics (Columbus, OH)
- …every decision we make. **Job Posting Title** Principal Underwriter - REMOTE **Job Description** The Principal Underwriter is responsible for achieving profit, ... guarantees and other financial considerations. **Responsibilities** + Evaluates the utilization and financial experience of customers and prospects; primarily… more
- Prime Therapeutics (Columbus, OH)
- …Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job Description** The Senior Director Clinical Strategy and Oncology ... implementation of innovative drug solutions, including optimizing optimize drug utilization , patient outcomes, and cost-effectiveness through value-based care models,… more
- Molina Healthcare (Akron, OH)
- …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
- Actalent (Cincinnati, OH)
- …of cases. Essential Skills + Experience in utilization management, concurrent review , prior authorization, utilization review , case management, and ... Job Title: Clinical Review Nurse 100% Remote Eastern and...Proficiency with InterQual. + Active Compact RN/LVN/LPN License. + Utilization Management/Concurrent Review experience. + ICU/ER experience.… more
- Anywhere Real Estate (Cincinnati, OH)
- …problems; + Work with the Engineering team to conduct design and peer code review ; + Acquire knowledge of existing systems and the underlying business processes they ... customers, analysts, data scientists, and operations teams which will increase the utilization of our products and achieve competitive advantage; + Remain abreast of… more
- Molina Healthcare (OH)
- …requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce errors and rework + Practice ... + Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare + Advanced knowledge of SQL + Proficient… more
- Sharecare (Columbus, OH)
- …techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also ... in the orientation and to take the pre and post tests to review competency during orientation. Yearly competency tests are required for all Sharecare clinicians.… more