- Novo Nordisk Inc. (Denver, CO)
- …Educators, Medical Liaisons) covering the same geographic areas. The Specialty Field Sales Representative actively shares information and plans to develop a ... HCPs (eg HEP/GI ) and key customers. Relationships Externally, the Specialty Field Sales Representative maintains relationships with physicians, pharmacists, nurses,… more
- CVS Health (Austin, TX)
- …specialty medication prior authorization (PA) requests reviewed by the Aetna Specialty Medical Prior Authorization department. Reporting to the Pharmacy ... is necessary and will involve computer system data entry, data management , and reporting. + Review criteria-based prior authorizations following policy and… more
- Aspen Medical (Aurora, CO)
- JOB AD: Registered Nurse- Utilization Management Introduction : Aspen Medical has an exciting opportunity for Registered Nurses to partner with us in ... Case Management through the American Nurses Credentialing Center or Utilization Management Accreditation through National Committee for Quality Assurance… more
- Intermountain Health (Las Vegas, NV)
- …, care management , claims, network management , and finance. As the Medical Director for Utilization Management , you are responsible, in partnership ... contributions toward quality improvement efforts. Serves as the chair of Quality Medical Management Committee (QMMC) and other designated committees defined by… more
- Ochsner Health (New Orleans, LA)
- …high quality, cost-effective, efficient patient care services + Utilization Management experience (preferred) + Familiarity with: Current medical literature, ... Utilization Review Physicians (ABQAURP) or (3) Physician Advisor Sub- Specialty Certification by the American Board of Quality Assurance...utilization of resources + Assist with the denial management process + Review medical records of… more
- AmeriHealth Caritas (Newtown Square, PA)
- …services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director, Utilization Management provides organizational ... and related policy and practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President,… more
- Crouse Hospital (Syracuse, NY)
- …years acute hospital experience. + Case Management or Utilization Management experience preferred. Benefits Overview: + Medical , Dental, Vision, FSA, and ... Crouse Health offers a full range of general and specialty care, inpatient and outpatient services, as well as...programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track… more
- Ascension Health (Nashville, TN)
- **Details** + **Department:** Utilization Management + **Schedule:** Monday - Friday. 40 hours a week. + **Hospital:** Ascension Saint Thomas + **Location:** ... TN market. We're looking for an experienced Director of Utilization Management to join our team! In...consisting of a network of hospitals, affiliated joint ventures, medical practices, clinics and specialty facilities. Ascension… more
- Commonwealth Care Alliance (Boston, MA)
- …and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets ... 013650 CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management , the Nurse Utilization Management (UM)… more
- AmeriHealth Caritas (Washington, DC)
- …**Responsibilities:** Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and ... most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health... will also be counted upon to: + Conduct utilization management reviews by assessing medical… more
