- Eliassen Group (San Diego, CA)
- **Oracle Fusion Consultant ** **10222 Barnes Canyon Rd, Bldg. 1 San Dieg, CA** **Type:** Contract **Category:** Business Analysis **Industry:** FH Migration ... user access governance, and compliance with applicable internal controls and quality standards. ▪ Participate in data migration, system integration, and system… more
- Elevance Health (Independence, OH)
- **Provider Relationship Account Consultant ** Carelon Behavioral Health Location: Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, ... companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive… more
- Cleveland Clinic (Beachwood, OH)
- …of high- quality care by maintaining a strong understanding of clinical standards, policies, and procedures while providing technical and operational support to ... most respected healthcare organizations in the world. As a **Technical Sales Support Consultant ** , you will be responsible for maintaining and supporting the growth… more
- UNUM (Chattanooga, TN)
- …applications) across Unum US product lines. The incumbent provides high quality , timely, and efficient medical consultative services to the Benefits Center. ... The Medical Consultant adheres to current regulatory, claim process, and internal...area of specialty + Minimum of five years of clinical experience in medical specialty + Strong team and… more
- US Tech Solutions (May, OK)
- …with unrestricted active license **Responsibilities:** + Reviews documentation and evaluates potential quality of care issues based on clinical policies and ... **Position Summary:** Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from … more
- CVS Health (Topeka, KS)
- …with flexible Weekdays **Position Summary** Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring ... spent at a desk and on the phone collecting and reviewing clinical information from providers. Precertification nurses use specific criteria to authorize… more
- CVS Health (Santa Fe, NM)
- …1993. We provide flexible, cost-effective care management solutions that promote high- quality healthcare for members. **Position Summary** We are seeking a dedicated ... 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… more
- US Tech Solutions (Chesapeake, VA)
- …healthcare costs and improve healthcare program/operational efficiency involving clinical issues Determines medical necessity/ appropriateness Facilitates optimal ... outcomes Identifies and follow through with continuous quality / compliance opportunities. May also include identification of aberrance's and initiation of corrective… more
- Community Health Systems (Enterprise, AL)
- …and evaluation. This role is responsible for coordinating and delivering high- quality care based on established clinical protocols and physician/provider ... and their families. **Essential Functions** + Coordinates and delivers high- quality , patient-centered care in accordance with organizational policies, protocols, and… more
- CVS Health (Austin, TX)
- …work schedule may include weekends, holidays and evening hours. - Utilizes clinical skills to coordinate, document and communicate all aspects of the ... and administration of the utilization/benefit management function. - Gathers clinical information and applies the appropriate medical necessity criteria/guideline,… more
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