- CVS Health (Jefferson City, MO)
- …compassionate. And we do it all with heart, each and every day. **Position Summary** The Quality Management Nurse (QM Nurse ) supports Aetna Better Health ... ensuring compliance with regulatory and accreditation standards while driving healthcare quality initiatives. This role combines clinical expertise with quality … more
- CVS Health (Jefferson City, MO)
- …we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and ... other products, services and/or programs * Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization * Consults and… more
- Fujifilm (Jefferson City, MO)
- …customers. + Ensure compliance with all applicable requirements of the company's quality management system. + Maintains effective communications and working ... **Position Overview** The Clinical Consultant , MI - I shall be responsible for... products and services. + Understand and apply appropriate quality management system processes. + Promote Company… more
- Insight Global (St. Louis, MO)
- Job Description Insight Global is looking for an experienced Medical Sales Consultant to join a Fortune 500 pharmaceutical companing selling oncology products and ... across a field territory in Orange County, CA. The Oncology Sales Consultant targets, will sell and promote oncology products to oncologists and other… more
- CVS Health (Jefferson City, MO)
- …to coordinate, document, and communicate all aspects of the utilization/benefit management program. + Conduct clinical reviews for adult inpatient behavioral health ... constituents in the coordination and administration of the utilization/benefit management function. + Gathers clinical information and applies the appropriate… more
- CVS Health (Raymore, MO)
- …members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention ... work. Services and strategies, policies and programs are comprised of network management , clinical coverage, and policies. Community Care Case Manager use a… more
- Centene Corporation (Jefferson City, MO)
- …Develop and maintain the audit process and tools related to: authorizations, appeals, quality events, and case management in CCMS; interrater reliability related ... and tools + Facilitate compliance with the auditing process + Act as a consultant related to system auditing to others in the unit, department and health plan… more
- Deloitte (Kansas City, MO)
- …interpersonal skills to collaborate with clinicians, physicians, NP/PAs, ancillary departments, Quality , Case Management , Finance, Revenue Cycle, and Coders + ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team...severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities… more
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