- CenterWell (Savannah, GA)
- …opportunities for education/coaching + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D per Member per ... early detection. The PL is responsible for executing the clinical strategy through the management of their own patient panel as well as those of the clinicians whom… more
- Point32Health (Canton, MA)
- …with the interdisciplinary care team, to improve member outcomes (ie, Utilization Management , Medical Director, pharmacy, community health workers, dementia ... Nursing Field (RN CM) will ensure that all members receive timely care management (CM) across the continuum, including transitions of care, care coordination and… more
- Health Care Service Corporation (Richardson, TX)
- …in all areas of BH Group Program integration and operations. 4. Direct health care management including utilization management (UM), care management (CM) ... to the executive director BH Clinical Operations in the inclusion, involvement, management , and visibility of the department, both internal and external to HCSC,… more
- ERP International (Anchorage, AK)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Dignity Health (Bakersfield, CA)
- …and CRM. - Provide backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer consultations, appeals and ... communication, issue resolution, and network expansion. They partner with Network Management and Contracting leadership to support the development of Physician/APP… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …nursing program. Must have three (3) years of clinical nursing experience. Referral Management (RM) and Utilization Management (UM) experience is preferred. ... Nurse (Non-Practicing) to support its contract with the Integrated Referral Management and Appointing Center (IRMAC), the National Capital Regions' premier… more
- ERP International (Hurlburt Field, FL)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- ERP International (Twentynine Palms, CA)
- …algorithms, CM software, and databases for community resources. * Integrate CM and utilization management (UM) and integrating nursing case management with ... sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40 states.… more
- Albany Medical Center (Albany, NY)
- …hospital clinical leadership, legal, compliance, billing, finance, IT, case and utilization management , quality, credentialing, and other related departments. ... the high level, multifaceted competencies needed for the implementation and management of payer contracting strategies including building solid external payer… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …as part of a core team. You'll collaborate cross-functionally with care management , utilization management , provider/member relations, and market-facing ... populations. **What** **you'll** **do:** + Develop oncology drug class specific management strategies including but not limited to trend forecasting & monitoring,… more