- Horizon Services, Inc. (Hayward, CA)
- …of front-line support and milieu staff to ensure full census and efficient utilization management at assigned program(s). Engages in marketing, client retention, ... youth prevention, youth and adult outpatient, sobering programs, withdrawal management , and co-occurring capable residential programs to support the well-being… more
- Prime Therapeutics (Trenton, NJ)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... cost solutions that meet the desired outcomes of the customer; general management of the account, including P&L responsibility; and accountability for contract… more
- CenterWell (Carson City, NV)
- …strategic planning, determining services, providers, and expected outcomes collaboratively. *Focus on utilization management and review provider schedules to ... initiatives, including Quality, HEDIS/STARs, AHCA, optimal patient scheduling, financial management , patient engagement, recruiting/hiring, and employee and patient retention.… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …will be responsible for establishing imaging protocols; reviewing imaging requests; utilization management ; ensuring appropriate preps and medication are ... section, service or facility level committees/boards, when assigned. Serve as Peer Reviewer for the Protected Peer Review Committee, when assigned. Demonstrate… more
- CenterWell (Morrow, GA)
- …opportunities for education/coaching + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D per Member per ... is responsible for executing the clinical strategy through the management of their own patient panel as well as...inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality… more
- CenterWell (Anderson, SC)
- …opportunities for education/coaching + Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D per Member per ... is responsible for executing the clinical strategy through the management of their own patient panel as well as...inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality… more
- Sargent Electric (Pittsburgh, PA)
- …Timely decisions and direction to ensure project profitability. + The proper utilization / management of Company-Owned and rented equipment. + Direct supervision ... office. The primary responsibility of this position is the successful supervision and management of construction activities, in the safest manner possible, up to and… more
- Molina Healthcare (Louisville, KY)
- …with multidisciplinary teams to promote Molina care model. * Adheres to utilization management (UM) policies and procedures. * May work collaboratively ... KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide...medical directors, and senior medical directors to ensure proper management of the BHT benefit. Required Qualifications * At… 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
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print...Review Nurse is an RN that has Case Management experience whose primary charge is to ensure that ... (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE SUPERVISOR I Salary $111,656.88 - $167,136.48 Annually… more