- WellSense (NH)
- …for our members, no matter their circumstances. **Job Summary:** The Provider Relations Consultant - NH will act as the primary liaison between Provider Relations ... as Claims, Benefits, Audit, Member and Provider Enrollment and Clinical Services to effectively identify and resolve claim issues....or Conditions of Employment:** + Must have valid driver's license and access to a car **Competencies, Skills, and… more
- University of Washington (Seattle, WA)
- …in the School of Medicine has an outstanding opportunity for a Research Consultant 2 (Temporary) to join their team. **Overview** This is a temporary position ... data quality and resolve outstanding queries. + Use critical thinking skills, clinical knowledge, and knowledge of medical terminology to interpret medical records… more
- KidsPeace Childrens Hospital (Bethlehem, PA)
- The Licensed Behavior Specialist (Behavior Consultant ) serves as the primary therapist on the Treatment Team, coordinating all treatment services for each client on ... ages of 5-21. Job Duties + Works as the clinical leader of the clients' treatment team in home,...supervision of a BCBA. + REQUIRED - Behavioral Specialist License Salary $50,000 Annual Salary with excellent benefits for… more
- UNUM (Portland, ME)
- …efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards ... (MD, DO, PhD, PsyD) + Active, unrestricted US medical license + Board certification required for physicians the preferred...or Occupational Medicine + Minimum of five years of clinical experience in medical specialty + Strong team and… more
- BD (Becton, Dickinson and Company) (Durham, NC)
- …and implementing continuous education improvements. The Sr. Training and Education Consultant will exhibit comprehensive knowledge of multiple MMS supported products ... technology. + Demonstrated experience training participants from diverse technical, clinical , and biomedical backgrounds. + Knowledgeable in the effective… more
- CVS Health (Raleigh, NC)
- …standards while driving healthcare quality initiatives. This role combines clinical expertise with quality improvement leadership, including clinical ... efforts with state and national quality goals. **Key Responsibilities** ** Clinical Review & Compliance** + Review and evaluate ...+ 2+ years as a Registered Nurse (RN) or License Practical Nurse/ License Vocational Nurse. +… more
- US Tech Solutions (May, OK)
- **Position Summary:** Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from ... clinical records or systems to apply appropriate ...support as required. Requires an RN with unrestricted active license **Responsibilities:** + Reviews documentation and evaluates potential quality… more
- CVS Health (Phoenix, AZ)
- …our remote team. In this role, you'll be at the forefront of clinical decision-making, applying your expertise in Behavioral Health to ensure members receive ... and compassion. **Key Responsibilities** + Apply critical thinking and evidence-based clinical criteria specific to Behavioral Health to evaluate inpatient and… more
- CVS Health (Springfield, IL)
- …each and every day. **Fully remote with requirement to have an RN license for Illinois.** **Schedule: Monday through Friday 8A-5PM CST** **Position Summary** - ... Utilizes clinical skills to coordinate, document and communicate all aspects...and administration of the utilization/benefit management function - Gathers clinical information and applies the appropriate medical necessity criteria/guideline,… more
- CVS Health (Austin, TX)
- …all with heart, each and every day. **Position Summary** Applies specialized clinical and industry knowledge and performance improvement best practices to quality ... address areas for improvement, reduce variations in care, and enhance clinical effectiveness. Establishes, tracks and monitors process and outcome measures. Prepares… more