- Prime Therapeutics (Austin, TX)
- …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 (Austin, TX)
- …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 (Austin, TX)
- …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 (Austin, TX)
- …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 (Austin, TX)
- …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
- Compass Group, North America (Dallas, TX)
- …while recommending long-term solutions to benefit productivity and margin enhancement. This is a remote role and will cover the Western US and Central US region. The ... and executing strategic purchasing initiatives to drive revenues and contract utilization . + Provide reporting to measure impact of culinary activities for… more
- Actalent (Dallas, TX)
- Clinical Review Nurse ( Utilization Management)100% Remote Job Description The role of the Utilization Management Nurse involves performing concurrent ... setting of care. Essential Skills + 2+ years of utilization management and utilization review ...+ Computer savvy. Work Environment This position is fully remote . Candidates can be located anywhere within Central or… more
- Molina Healthcare (Dallas, TX)
- …(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
- NexTec Group (TX)
- …(with minimal guidance and oversight) within alignment of SOW, Business Process Review (BPR) documentation, and NexTec methodology. + Maintaining 70 percent or ... higher utilization on an average annual basis. + Maintaining appropriate...with customers. + Following NexTec implementation methodologies. + Achieving utilization targets while achieving high customer satisfaction. Education and… more
- Actalent (Houston, TX)
- …of cases. Essential Skills + Experience in utilization management, concurrent review , prior authorization, utilization review , case management, and ... planning. + Proficiency with InterQual. + Active Compact RN License. + Utilization Management/Concurrent Review experience. + ICU/ER experience. + Strong… more