- Centene Corporation (Jefferson City, MO)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks...applicable guidelines, policies, and procedures + Works with the senior management to develop and implement UM… more
- Commonwealth Care Alliance (Boston, MA)
- …Director will be responsible for providing leadership and subject matter expertise to our utilization management (UM) group. This role is a key role in helping ... other medical management team members. + Support the development of utilization management policy initiatives. + Support the development and implementation… more
- Sharp HealthCare (San Diego, CA)
- …to accrediting and regulatory agency feedback. + Supports pre-admission review, utilization management , and concurrent and retrospective review Process. Performs ... risk management reviews. + Assists in pharmacy utilization management , catastrophic case review, outreach programs,...CMO CPTAC and Peer Review Committees. + Partners with Senior Management including CMO and COO to… more
- Veterans Affairs, Veterans Health Administration (Kerrville, TX)
- …similar role or with population served. Clinical supervision certification. Quality or utilization management experience. Former VA Trainee. Reference: For more ... Summary The Senior Social Worker (HUD-VASH Kerrville) provides clinical intervention and case management support for the Homeless Veterans Program in the Kerr… more
- Humana (Nashville, TN)
- …Horizons is seeking a Senior Compliance Nurse Professional who ensures utilization management and complex case management processes and procedures ... Compliance Professionals to ensure state specific contractual requirements are met regarding utilization management , complex case management , and clinical… more
- Amentum (Washington, DC)
- …at the logical level working with communication protocols. The Systems Engineer ( Senior ) will perform systems management and integration functions. You will ... are searching for a Top Secret cleared Systems Engineer ( Senior ) to join our team in Washington, DC. You...hardware and operating systems including the evaluation of system utilization , monitoring response time and primary support for detection… more
- Veterans Affairs, Veterans Health Administration (Abilene, TX)
- …Social Work: vacareers.va.gov/wp-content/uploads/sites/5/Total-Rewards-of-a-Social-Worker-Career-Flyer.pdf The Senior Social Worker: provides clinical ... working knowledge and skill in the use of business productivity software, data management , and computer systems/programs, especially those programs in use by VHA. is… more
- University of Rochester (Rochester, NY)
- …management , clinical services, pharmacy data analytics, and pharmacy procurement/inventory management . The Senior Director, Ambulatory Pharmacy Services in ... individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: The Senior Director, Ambulatory Pharmacy Services is responsible for the… more
- L3Harris (Palm Bay, FL)
- …land, sea and cyber domains in the interest of national security. Job Title: Senior Associate, Physical Security Officer Job Code: 25327 Job Location: Palm Bay, FL ... motion detectors, and alarm panels. * Update and maintain records, ie, accreditation packages, approvals, (eg, database and hardcopy), current and accurate co-… more
- Veterans Affairs, Veterans Health Administration (Cheyenne, WY)
- …which has as its focus: prevention; health promotion; coordination; and chronic disease management . The Senior Social Worker actively participates as a member of ... Summary Cheyenne Veterans Affairs Medical Center is hiring PACT Senior Social Worker. This position is located in Cheyenne Veterans and may be eligible for Telework… more