- Fresenius Medical Care (Hayward, WI)
- …training courses and that licensures/certifications are current. Provides support for all clinical staff members at regular intervals and encourages professional ... patient eligibility for treatment. Reports changes in patient status regarding any clinical , insurance, or travel and transportation issues. STAFF : Participates… more
- Fresenius Medical Center (Fitchburg, WI)
- …as a resource to facility staff . + Provides counseling for all clinical staff members at regular intervals offering support and encouraging professional ... to the disease management company. Maintains current knowledge of disease management software and systems as pertinent. ** STAFF :** + Responsible for… more
- Fresenius Medical Center (Sheboygan, WI)
- …courses and that licensures/certifications are current. + Provides support for all clinical staff members at regular intervals and encourages professional ... eligibility for treatment. + Reports changes in patient status regarding any clinical , insurance, or travel and transportation issues. STAFF : + Participates… more
- Humana (Madison, WI)
- …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 (Madison, WI)
- …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
- Evolent (Madison, WI)
- … Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Molina Healthcare (Madison, WI)
- JOB DESCRIPTION Job SummaryProvides support for pharmacy Medication Therapy Management (MTM) activities. Contributes to overarching pharmacy strategy to ensure ... in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices. *… more
- Highmark Health (Madison, WI)
- …per week (Tuesday-Thursday).** This role supports the full application product lifecycle for ** clinical and utilization management software** , with a ... and technical teams. They function as a pivotal bridge, translating high-level ** clinical and utilization management software** business needs into… more
- Genesis Healthcare (Eau Claire, WI)
- …oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification is overseen by a licensed ... oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification is overseen. Qualifications 1.… more
- Veterans Affairs, Veterans Health Administration (Tomah, WI)
- …Formulary and Drug Utilization Manager position is responsible for managing medication utilization data and educating providers and staff in proper resource ... Summary The Formulary and Drug Utilization Manager position guides the appropriate medication use...communicate orally and in writing to persuade and influence clinical and management decisions. Expert understanding of… more
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