- CVS Health (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …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 (Jefferson City, MO)
- …Must have active current and unrestricted RN licensure in state of residence + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area- + Managed Care experience preferred, especially Utilization Management + Preference for those residing in Central and Mountain… more
- Prime Therapeutics (Jefferson City, MO)
- …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 (Jefferson City, MO)
- **_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 (Jefferson City, MO)
- … 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
- Elevance Health (St. Louis, MO)
- …role required by a State agency. **Preferred Skills, Capabilities, and Experiences:** + Utilization Management experience is a plus. + Ability to meet necessary ... reviews. + The Medical Director typically has program management responsibilities including clinical policy development, programdevelopment/implementation,and… more
- Elevance Health (St. Louis, MO)
- …work East Coast time zone hours.** The **Medical Director** will be responsible for utilization review case management for Commercial business in the New England ... programs to improve quality, cost, and outcomes. May provide clinical consultation and serve as clinical /strategic advisor...discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May… more
- HCA Healthcare (Independence, MO)
- …with other health care team members by serving as a manager, clinical practitioner, educator, consultant , and researcher. Responsible for monitoring and ... an autonomously functioning Registered Nurse who, because of education and in-depth clinical experience, possesses knowledge and clinical skills necessary to… more