- Humana (Salt Lake City, UT)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- University of Utah Health (Salt Lake City, UT)
- …communication skills. + Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. + The ability to ... to UR committee any case that surpasses expected LOS, expected cost, or over/under- utilization of resources. + Performs verbal/fax clinical review with payer as… more
- Philips (Salt Lake City, UT)
- As a Clinical Specialist with our Lead Management team you will provide clinical expertise and organic revenue generation and growth to drive customer ... sustain Health Care Provider Education efforts, and help drive full product portfolio utilization to meet the needs of our customers. **Your role:** + Conducting… more
- University of Utah (Salt Lake City, UT)
- …and materials to facilitate patient education and discharge planning. 4. Provides clinical education to nursing staff , students, faculty and hospital personnel. ... designed to promote individual, groups and organizational performance. 11. Promotes the utilization of research findings in clinical practice. Facilitates and/or… more
- Highmark Health (Salt Lake City, UT)
- …and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or ... Utilize robust, data-driven insights from complex healthcare datasets (eg, claims, clinical , utilization , pharmaceutical) to inform policy development, identify… more
- University of Utah Health (Salt Lake City, UT)
- …supplies and serves as a liaison between hospital administration, departments, medical staff and UHC to ensure cost-effective utilization of products, included ... collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation,… more
- Deloitte (Salt Lake City, UT)
- …plans for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education ... clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist, utilization review, informatics RN, Quality, DRG… more
- Humana (Salt Lake City, UT)
- …corporate communications to be shared with senior leadership. + Supports trend management by conducting analysis of drug spend, utilization , and/or approval ... communicating with staff in different positions and all levels of management positions + Manages the Humana Michigan FIDE-SNP health plan relationship with our… more
- Evolent (Salt Lake City, UT)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse… more
- Prime Therapeutics (Salt Lake City, UT)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... visa or residency sponsorship **Additional Qualifications** + 3-5 years' experience in clinical operations, quality, network, pharmacy or project management OR a… more
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