- St. Bernard's Medical Center (Batesville, AR)
- … Management /Social Work staff and Administration to assure insurance process and utilization review flows smoothly. Maintain good relations with clinics and ... supplies up to 20 lbs. + JOB SUMMARY + The Pre-Authorization Reviewer is responsible for collecting appropriate pre-authorization information and verifying coverage… more
- CVS Health (Providence, RI)
- …initiatives. You will be responsible for consulting with network and clinical management on opportunities to improve our company's discount position and strategic ... cost and utilization initiatives and is essential to managing conflicting priorities...and multiple projects. As part of the Medical Expense Review (MER) team, you will prepare for monthly presentations,… more
- Balchem (Faribault, MN)
- … management ; conducts investigations and recommends corrective action; assists management in the utilization of constructive communication, including ... business interests. Provides counsel, services, and other assistance to departments and management to assist them in the effective execution of their personnel and… more
- Mount Sinai Health System (New York, NY)
- …to: 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using standardized ... (CM) will be responsible for all aspects of case management for an assigned group of inpatients to determine...Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or… more
- City of Detroit (Detroit, MI)
- …inventory system providing ease of access as audit requests are made *Reports to management about asset utilization and audit results and recommends changes in ... a result of periodic audits *Manages and provides oversight over the utilization of various City tax abatements, primarily regarding housing and mixed-use… more
- Elevance Health (Las Vegas, NV)
- …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license ... in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and… more
- Gilead Sciences, Inc. (Foster City, CA)
- …change over time, our initial need is for an expert in Material Review platforms (Veeva MedInquiry, VeevaVault, MedDocs, etc). Responsibilities include but are not ... + Hands on experience administering and deploying platforms for Material Review (Veeva MedInquiry, VeevaVault, MedDocs) preferred. + Additional certifications in… more
- Actalent (West Des Moines, IA)
- …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... + Collects, documents, and maintains all member's clinical information in health management systems to ensure compliance with regulatory guidelines + Assists with… more
- Texas A&M University - Faculty (College Station, TX)
- Tenure-Track/Tenure Review Upon Hire: Open Rank (Assistant Professor, Associate Professor, Full Professor) Pharmaceutical Sciences Location College Station Open Date ... Pharmacy in the Department of Pharmaceutical Sciences. This is an 11-month, tenure-track/tenure review upon hire position in College Station , and the start date is… more
- University of Colorado (Colorado Springs, CO)
- …with the Assistant Director of Business Operations leads member services including the utilization and organization of member management software and assists in ... the health and safety of our participants. + Assists with the review and management of incident and accident/injury reports. + Collaborates with the facilities… more