- The Cigna Group (Bloomfield, CT)
- …post residency/fellowship + Knowledge of applicable state federal laws + Utilization Review Accreditation Commission and National Committee for Quality ... providers and stay current on healthcare regulations and industry developments as you review a wide range of cases. This role offers you the opportunity to… more
- Sharecare (Helena, MT)
- …techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also ... in the orientation and to take the pre and post tests to review competency during orientation. Yearly competency tests are required for all Sharecare clinicians.… more
- Molina Healthcare (GA)
- …guidelines + Coordinate the Market month-end close with Accounting staff; review all non-IBNR reserves for appropriateness monthly + Work collaboratively with ... impacting IBNR, including bed days and admits per 1,000, prescription drug utilization , billed dollars of inventory, and other measurable factors that may be… more
- The Cigna Group (Bloomfield, CT)
- …Cigna Medical Sales organization + Participate in client meetings and presentations to review client performance and to offer and successfully sell in a suite ... finalist meetings for new and existing business where necessary + Analyzes pharmacy utilization in order to provide clients with consultative solutions as well as… more
- Molina Healthcare (TX)
- …multiple data sources, crosswalks, and built-in validation checks. + Use peer-to-peer review process and end-user consultation to reduce errors and rework. + Assist ... Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare + Advanced knowledge of Databricks +… more
- CareFirst (Baltimore, MD)
- …be responsible for generating and manipulating data/reporting (claims, billing, utilization ) for CoC insights and opportunities. Experience in utilizing healthcare ... to support clear communication across across vertical components of business. Review and support task coordination while identifying potential process improvements.… more
- Stanford Health Care (Palo Alto, CA)
- …+ ICU/ED and Academic Medical Center experience preferred. + Case management, utilization review and/or direct provider interaction experience, preferred. + ... Experience in public speaking, as well as educational content creation and delivery of formal multidisciplinary education, preferred. + Experience with Vizient, Premier, Elixhauser and other risk adjustment methodologies, highly preferred. **Required… more
- The ODP Corporation (Boca Raton, FL)
- …an ongoing basis and for building relationship across Marketing and BU owners. Review and make recommendations for the improvement of our processes and technology. ... and can multi-task * Timely communication and meets deadlines * Effective utilization of hardware and software applications and equipment * Strategic and creative… more
- M. C. Dean (Vienna, VA)
- …separated data center and the installed assets, power, cooling, and space utilization . This role requires a strong understanding of DCIM tools, data analytics, ... + Coordination with facility floor managers regarding existing zoning + Review of DISA mechanical & electrical projects to determine planned/assumed zoning… more
- The Cigna Group (Denver, CO)
- …clients and preserve earnings. + Participate in client meetings and presentations to review client performance and sell in the suite of pharmacy management programs ... the medical sales teams. + Support detailed ad-hoc analysis of pharmacy claims utilization in order to provide clients with proactive consultation, as well as manage… more