- CVS Health (Little Rock, AR)
- …promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team . **Position Summary** The ... a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective...projects. Acting as the first point of contact for clinical issues, the Team Lead provides guidance… more
- CVS Health (Little Rock, AR)
- …compliance and privacy practices. + Oversees the implementation of utilization management services for assigned area + Implements clinical policies & ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- CVS Health (Little Rock, AR)
- …years of MS office suite experience. **Preferred Qualifications** + Experience with multiple clinical systems. + Utilization Management experience. + Ability ... members. **Position Summary** The Associate Manager is responsible for oversight of Utilization Management staff. This position is responsible for the… more
- Humana (Little Rock, AR)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...Management RN working on the OneHome/Home Solutions UM Team , you will have the opportunity to use your… more
- Humana (Little Rock, AR)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...to work independently under general instructions and with a team + Must be passionate about contributing to an… more
- CenterWell (Little Rock, AR)
- …caring community and help us put health first** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical ... peak season **Job Description:** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional...ability to work effectively both independently and in a team environment + Strong problem-solving skills and the ability… more
- Humana (Little Rock, AR)
- …put health first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... at Humana. Join Us!** The UM Administration Coordinator provides non- clinical support for the policies and procedures ensuring best...care or services for members. The Home Solutions UM Team is hiring for a UM Administration Coordinator that… more
- Prime Therapeutics (Little Rock, AR)
- …Develop and present clinical program solutions, including formulary and utilization management recommendations, to Administrative Services Only (ASO) groups ... understand current industry trends and illustrate expert knowledge of clinical products and formulary management strategies in...utilization patterns and trend impact + Support account team in sales and retention efforts, formulary and … more
- CVS Health (Little Rock, AR)
- …of Care: + Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and ... with their provider in healthcare decision-making + Analyzes all utilization , self-report and clinical data available to...+ In collaboration with the member and their care team develops and monitors established plans of care to… more
- CenterWell (Hope, AR)
- …a part of our caring community and help us put health first** The RN Clinical Manager enables patients to stay in their homes by providing health and personal ... services, supporting patients and their families. The RN Clinical Manager works within specific guidelines and procedures; applies advanced technical knowledge to… more