- Molina Healthcare (Lincoln, NE)
- …such meetings would occur to discuss and resolve issues related to utilization management , pharmacy , quality of care, and correct coding. * Independently ... and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability… more
- Molina Healthcare (Ann Arbor, MI)
- …Such meetings would occur to discuss and resolve issues related to utilization management , pharmacy , quality of care, and correct coding, for example. + ... **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and… more
- Humana (Miramar, FL)
- …referral management education to members and providers regarding medical benefits , referral status and prior authorizations. Communicate with patient to confirm ... source and provider interactions and communications. Work with Pre-Authorization, Utilization Management , Billing, Pharmacy , Home Care and DME regarding referred… more
- AmeriHealth Caritas (LA)
- …those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health ... management as needed. The BH UM Reviewer will apply medical health benefit policy and medical management guidelines to authorize services and appropriately… more
- HCA Healthcare (Independence, MO)
- …Active pharmacist license in good standing with the appropriate State Board of Pharmacy + State Specific Medications Therapy Management Certification + At least ... 7pm-6:30 (overlap 30 minutes with "2" pharmacist who comes in at 6:00am)** ** Benefits ** Centerpoint Medical Center offers a total rewards package that supports the… more
- HCA Healthcare (Independence, MO)
- …Active pharmacist license in good standing with the appropriate State Board of Pharmacy + State Specific Medications Therapy Management Certification + At least ... to support our incredible team members over the course of three years. ** Benefits ** Centerpoint Medical Center offers a total rewards package that supports the… more
- HCA Healthcare (Independence, MO)
- …Active pharmacist license in good standing with the appropriate State Board of Pharmacy + State Specific Medications Therapy Management Certification + At least ... your application for the opportunity below:Clinical PharmacistCenterpoint Medical Center ** Benefits ** Centerpoint Medical Center, offers a total rewards package that… more
- AbbVie (North Chicago, IL)
- …reduction, capacity increase, etc.) that lead to process remediation. + Project management of smaller team sub-projects in support of larger projects. Responsibility ... may include project coordination, monitoring, reporting, meeting management , and team communication. + Lead the implementation of process validation for technology… more
- Sutter Health (Los Altos, CA)
- …and recurrent issues, and recommends and implements course of action. FINANCIAL MANAGEMENT : * Assists in meeting financial targets by effectively managing and ... of medical terminology and insurance. + Familiarity with general hospital management principles, practices, and procedures. + Knowledge and understanding of… more
- Flynn Restaurant Group (Independence, OH)
- …including Medicare reporting. + Oversee vendor partnerships (eg, defense firms, nurse case management , pharmacy benefit managers) to optimize outcomes and ... and program performance. Reporting to the Director of Risk Management , the Workers' Compensation Claims Manager will partner closely...Work For Flynn?** Flynn Group offers a variety of benefits and perks to encourage and empower our employees.… more