- Humana (Juneau, AK)
- …Degree or BSN degree. + Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + ... help us put health first** We are seeking a Senior Accreditation Professional who will work in...on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming … more
- Centene Corporation (Columbus, OH)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... OF OHIO IDEAL CANDIDATE WILL HAVE PRIOR AUTHORIZAION OR UTILIZATION MANAGEMENT EXPERIENCE PEOPLE LEADER EXPERIENCE STRONGLY...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 (Mcallen, TX)
- …Community Mental Health Recovery-Rural Access Network for Growth Enhancement (ICMHR-RANGE) Senior Social Worker is directly responsible to the Recovery Services ... primary outpatient mental health providers for the Veterans they serve. The ICMHR Senior Social Worker: May be assigned direct clinical program management … 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 (El Paso, TX)
- …for violence and other safety-compromising behaviors Engaging best practices in threat management to prevent violence in the workplace in accordance with applicable ... Federal, local and Tribal laws, directives and policies Responsible for management of computer-based flagging systems for identifying potentially violent or… 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
- Centene Corporation (New York, NY)
- …VPMA responsibility in absence of VPMA. + Provide medical leadership for all utilization management , pharmacy, case management , disease management , ... Provide medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… 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