- Cardinal Health (Tewksbury, MA)
- …DCOA as an objective tool to work with specific Medical Staff Departments or Utilization Management Teams to improve medication utilization + Ensures ... System Director of Pharmacy (HSD), Director of Pharmacy Operations and Account Management , and Cardinal Health Clinical Director, the Health System Clinical Director… more
- Molina Healthcare (WA)
- …care or medical or behavioral health settings. Prior experience in Utilization Management and discharge planning. **Preferred License, Certification, ... Association** Active, unrestricted Certified Case Manager (CCM) Some experience with Utilization Management processes is desirable (InterQual, MCG guidelines) ,… more
- The Cigna Group (Bloomfield, CT)
- …external customers. He/she will serve as a clinical educator and consultant to utilization management , case management , network, contracting, pharmacy, and ... in CMS' Preclusion List** **Preferred Skill Sets:** + Experience in medical management , utilization review and case management in a managed care setting.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
- CDPHP (Latham, NY)
- …of consistent and quality health care services. Examples may include: Utilization Management , Quality, Behavioral Health, Pharmacy, Registered Dietitian and ... within the group. + Responsible for all aspects of the Case Management department functions including quality, productivity, utilization performance, and… more
- CVS Health (Tallahassee, FL)
- …outcomes. * Leverage extensive knowledge of health care delivery system, utilization management , reimbursement methods and treatment protocols for DSNP/MMP ... Health, Pharmacy, Member Outreach, Care Management , National Quality Management , Utilization Management , Compliance, and other departments to integrate… more
- University of Southern California (Alhambra, CA)
- …of specific patient populations. The role integrates the functions of complex case management , utilization management , quality management , discharge ... + Req 5 years Clinical experience + Req 2 years Ambulatory case management or utilization review experience within the last three years + Req Ability to work… more
- The Cigna Group (Bloomfield, CT)
- …leadership and oversight for all medical management functions, including case management (CM), utilization management (UM), and escalated case review. ... operating within health plan environments, including fluency in medical management functions such as utilization management (UM), case management (CM),… more
- Intermountain Health (Butte, MT)
- …+ Provide leadership and expertise to ensure that medical quality improvement and utilization management programs are carried out in clinical areas through the ... + Develop, implement and monitor medical policies and procedures (including case /disease management , utilization management and clinical programs) as they… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Coordination Specialist provides administrative support for any of the programs of Utilization Management , Behavioral Health, Quality Management , or Member ... tasks under pressure. + Demonstrates proficiency in basic navigation and utilization of department specific applications: care management system, department… more