- Centene Corporation (Atlanta, GA)
- …knowledge of regulations, accreditation standards, and industry best practices related to utilization management + Works with utilization management ... Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. **(Must reside in Georgia).** + Monitors and… more
- Commonwealth Care Alliance (Boston, MA)
- …and has a deep understanding of the available tool packages for utilization management (CMS guidelines, MassHealth guideline, McKesson Interqual, MCG Health's ... Reporting to the Health Plan Chief Medical Officer, the Senior Medical Director for Utilization Review will...plan or combination thereof + Subject matter expertise in medical/ utilization management review and health plan clinical… 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
- RWJBarnabas Health (Oceanport, NJ)
- …standards. + Leads payer audit response, clinical denial recovery, and utilization management integration efforts to support mid-cycle revenue integrity. ... Management Location: System Business Office, 2 Crescent Place, Oceanport, NJ 07757 Senior Vice President, Revenue Cycle Management Job Overview: The Senior… more
- Entergy (The Woodlands, TX)
- **Job Title:** Senior Category Management Specialist **Work Place Flexibility:** Hybrid **Legal Entity:** Entergy Services, LLC **Please note:** Authorization to ... assistance may be available for this posting.** **Job Summary/Purpose** The Senior Staff Category Management Specialist utilizes extensive supply chain,… 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 (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
- 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
- Veterans Affairs, Veterans Health Administration (Cheyenne, WY)
- …which has as its focus: prevention; health promotion; coordination; and chronic disease management . The Senior Social Worker actively participates as a member of ... Summary Cheyenne Veterans Affairs Medical Center is hiring PACT Senior Social Worker. This position is located in Cheyenne Veterans and may be eligible for Telework… more
- Veterans Affairs, Veterans Health Administration (Pembroke, NC)
- …under Behavioral Health Service Line - Social Work Division. The Caregiver Support Senior Social Worker is assigned to the CSP with responsibility to provide ... Total Rewards of a Allied Health Professional The Caregiver Support Senior Social Worker develops and implements the Caregiver Support Program specific… more