- Ascension Health (Wauwatosa, WI)
- …matter expert in pharmacy discipline and provide guidance across pharmacies and to clinical leadership. + Review and assess medication orders to identify, ... prevent and resolve potential and actual drug related problems. + Recommend formulary alternatives when appropriate. + Compound and dispense medications for accurate delivery to patients. + Provide drug information and education to medical staff and patients.… more
- Cardinal Health (Lewiston, ME)
- …in research that is within the scope of pharmaceutical care and/or pharmacoeconomics. Review clinical literature that is supportive for all clinical ... team on prescribed medications, supplies and related processes. **_Job Summary_** The Clinical Pharmacy Manager is responsible for overseeing the clinical … more
- Centene Corporation (Salem, OR)
- …all appeal letters generated comply with both State and NCQA requirements. + Review clinical information for all appeals utilizing nationally recognized criteria ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Cognizant (Annapolis, MD)
- …and retro-authorization as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral, preauthorization, ... the medical necessity determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and… more
- NORC (Washington, DC)
- …+ Expert knowledge of pharmaceutical drug utilization practices and treatment recommendations, clinical practice guidelines review , FDA label review , ... + Lead and contribute to growing NORC's portfolio in clinical practice and prescription drug policy and research, specifically...and promotions, which is overseen by a formal Salary Review Committee (SRC)._ **WHAT WE DO:** NORC at the… more
- Elevance Health (Dearborn, MI)
- …decisions that are within the scope of practice that is relevant to the clinical area under review . + Provide reviews for predetermination of medical necessity. ... inconsistent with the CBA, the CBA provisions will prevail._** The ** Clinical Care Manager II** provides assessments, referrals, and counseling. Conducts telephone… more
- Johns Hopkins University (Baltimore, MD)
- …with students and preceptors and ensure any issues are addressed promptly. + Review clinical hours and grade patient logs providing constructive feedback to ... with the Course Coordinator/Track Director prior to implementation. + Review and validate student clinical hours and preceptor verification of clinical hours… more
- CVS Health (Phoenix, AZ)
- …disorders. + Make recommendation for enhancements to current managed care, review guidelines, and clinical criteria based on extensive knowledge ... of fraud and abuse. + Researches and prepares cases for clinical and legal review . + Provides day-to-day support and guidance for ABA prior authorization… more
- New York State Civil Service (Schenectady, NY)
- …behavioral, community problems and social issues.* Participates in complex assessments and or review clinical documentation as part secondary review to ... in receipts of services in state operated programs.* Collects, review , analyze and present data/metrics tied to clinical... review , analyze and present data/metrics tied to clinical and/or performance measures and utilize data to improve… more
- OhioHealth (Columbus, OH)
- …flexibility when working on multiple projects. Participates in meetings with OHRI, PI and clinical teams to review patient status at a detailed level. Works with ... - in our careers and in our communities. **Job Description Summary:** The Clinical Consultant Research works in collaboration with the Principal Investigator (PI) to… more