- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …utilization. Routinely collaborate with other departments including but not limited to Clinical , Regulatory, Quality and Data Management . Other ... + Collaborate with PV Quality and Compliance and Safety Data Management to develop monitoring reports and...related problems and concerns to CS team members and management in a timely manner; participation in clinical… more
- US Tech Solutions (Columbia, SC)
- … clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis ... **Duration: 3+** Months (Possible contract to hire) **Job Description:** + Onsite training...Services, Subrogation, Quality of Care Referrals, etc.). Participates in data collection/input into system for clinical information… more
- Houston Methodist (Katy, TX)
- …is responsible for the integration and advancement of a unified case management model grounded in clinical excellence, throughput efficiency, care transitions, ... and other areas according to functional area specifications. + Performs vendor management functions and oversees contract negotiation, contract development,… more
- Huron Consulting Group (Chicago, IL)
- …Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new ... partnerships, clinical services and technology is not enough to create...internal processes and deliver better consumer outcomes. The Vendor Management Manager provides management of standardized vendor… more
- University of Southern California (Los Angeles, CA)
- …assigned caseload. * Assess physical and biopsychosocial needs of the patient through clinical assessment and utilizing data from multiple sources. * Analyze and ... M drive. * Maintains awareness of current managed care contract requirements. * Participates in appeal process. * Performs...+ Req Associate's Degree Nursing + Req 3 years Clinical experience. + Req Knowledge of case management… more
- Hackensack Meridian Health (Edison, NJ)
- …(IT VMO) at Hackensack Meridian Health (HMH) by overseeing IT vendor relationships, contract negotiations, and performance management . Reporting to the IT VMO ... required in Edison, NJ. The ideal candidate will have proven expertise in contract life cycle management across XaaS, Software, Hardware, Network, and Managed… more
- University of Southern California (Los Angeles, CA)
- The Senior HIM Coding Denials Management Specialist is a seasoned inpatient coding professional or coding auditor responsible for triaging, identifying payer's ... This role operates at the intersection of medical coding, billing, clinical documentation, and payer compliance, ensuring accurate claim submission, effective… more
- Mount Sinai Health System (New York, NY)
- …role drives cost-effective, high-quality post-acute care through strategic partnerships, data -driven performance oversight, clinical and operational leadership, ... across the care continuum. The role requires a proactive leader with strong clinical insight, analytical capabilities, and change management expertise who can… more
- Humana (Little Rock, AR)
- …of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and… more
- Charles River Laboratories (Charleston, SC)
- …the subject matter expert (SME) for all vendor contracts, conducting thorough contract reviews. * Collaborate cross-functionally with Product Management and key ... management , procurement, sourcing, or related role. * Demonstrated experience in contract negotiation and management , including a solid understanding of… more