- CVS Health (Frankfort, KY)
- …- SEE REQUIRED QUALIFICATIONS FOR LICENSING DETAILS_** This is a fulltime remote Utilization Management Clinical Consultant opportunity with Aetna ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable… more
- CVS Health (Frankfort, KY)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Frankfort, KY)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects… more
- CVS Health (Frankfort, KY)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Utilizes clinical experience and skills ... is URAC accredited in Case Management , Disease Management and Utilization Management . AHH...that support cost-effective quality care for members. Work in clinical telephone queue for 3 to 4 hours a… more
- CVS Health (Frankfort, KY)
- …3+ years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in… more
- CVS Health (Frankfort, KY)
- …- active license. + 3+ Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Must have active ... shift premium. Occasional Overtime may be required. **Position Summary** Utilizes clinical experience and skills in a collaborative process to implement, coordinate,… more
- Prime Therapeutics (Frankfort, KY)
- …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Management Consultant - Remote **Job Description** The Network Management ... Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply… more
- Cardinal Health (Frankfort, KY)
- **_What Specialty Networks contributes to Cardinal Health_** Specialty Networks creates clinical & economic value for independent specialty providers & partners in ... Networks in creating value to the members in their clinical , operational, and economical goals. This individual will be...Member Profiles and overall success of membership network with utilization and optimization of Salesforce keeping up to date… more
- Eliassen Group (Frankfort, KY)
- … to support the implementation of Workfront as an Enterprise Portfolio and Project Management tool. As the Senior Consultant , you will work closely with our ... **Workfront Configuration Consultant ** **Anywhere** **Type:** Contract **Category:** Development **Industry:** Insurance **Workplace Type:** Remote **Reference ID:**… more
- CVS Health (Frankfort, KY)
- …Friday 8:00am - 5:00pm in time zone of residence_** **Preferred Qualifications** - Utilization Management review - Managed Care experience - Client processing ... day. **Position Summary** Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained… more
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