- Alameda Health System (Oakland, CA)
- …each individual in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and performance evaluations. ... utilization reviews and determine program improvements. Develop and implement utilization review policies and procedures in accordance with industry… more
- Buckeye Community Health Plan (Thornville, OH)
- … management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review , quality ... of physician education with respect to clinical issues and policies. Identifies utilization review studies and evaluates adverse trends in utilization… more
- CenterWell Home Health (Pittsfield, MA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... and documentation requirements. Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review … more
- Christus Health (Texarkana, TX)
- …therapy department. Participates in medical chart peer review , case record review and utilization review as deemed necessary. Assumes responsibility ... for therapeutic equipment safety, operation and maintenance. Requirements: Education/Skills Basic Computer Knowledge Ability to communicate effectively, both verbally and written. Graduate of an accredited occupational therapy program. Experience New graduate… more
- Christus Health (Wake Village, TX)
- …and procedures manual. Participates in medical chart peer review , case records review and utilization review as deemed necessary by management. Performs ... all other duties as assigned. Requirements: Education/Skills Masters level degree in speech language pathology is required. Basic Computer Knowledge Ability to communicate effectively, both verbally and in writing. Experience New graduate entry level or any… more
- Christus Health (Leary, TX)
- …and procedures manual. Participates in medical chart peer review , case records review and utilization review as deemed necessary by management. Performs ... all other duties as assigned. Requirements: Education/Skills Masters level degree in Speech Language Pathology is required Basic computer knowledge Ability to communicate effectively, both verbally and written Experience New graduate entry level or any amount… more
- Christus Health (Red Lick, TX)
- …and procedures manual. Participates in medical chart peer review , case records review and utilization review as deemed necessary by management. Performs ... all other duties as assigned. Requirements: Education/Skills Masters level degree in speech language pathology is required. Basic Computer Knowledge Ability to communicate effectively, both verbally and in writing. Experience New graduate entry level or any… more
- Lourdes Health (Pasco, WA)
- …fosters an environment that encourages professional growth. Initiates weekend case management, Utilization review screening, assists with D/C planning and swing ... intake. How you'll contribute You'll make an impact by utilizing your specialized plan-of-care intervention and serving as a patient-care innovator. You will shape exceptional patient journeys every day and leverage your skills and our cutting-edge technology… more
- Triangle Springs (Raleigh, NC)
- …patient's treatment. Works well with the interdisciplinary team including physicians, utilization review and nursing staff members Demonstrates active ... communication with team members Effectively communicates to UR on treatment and LOS issues Completes appropriate paperwork for clients in a timely, accurate and complete manner Demonstrates appropriate crisis intervention and de-escalation skills Acts as a… more
- Lourdes Health (Pasco, WA)
- …fosters an environment that encourages professional growth. Initiates weekend case management, Utilization review screening, assists with D/C planning and swing ... intake. How you'll contribute You'll make an impact by utilizing your specialized plan-of-care intervention and serving as a patient-care innovator. You will shape exceptional patient journeys every day and leverage your skills and our cutting-edge technology… more
- Interim HealthCare (Greenwood, IN)
- …Nurse (RN) in home health or similar setting; previous case management/ utilization review experience preferred. OASIS experience preferred. Practical trach ... and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best is non-negotiable - that's why we treat your family like our own. We take a patient-centric approach to address each individual's mind, body, and spirit,… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …regulatory entities. Collaborates with Senior Medical Director to resolve complex medical review issues and utilization cases requiring elevation to the Senior ... 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an...Ensures timely responses to all requests related to medical review decisions and authorization issues from EOHHS, CMS and… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …including specimen identifiers and metadata, and ICF-associated permissions prior to utilization .Collaborate with Procurement to review contracts and ensure ... qualification for biorepository vendors responsible for long-term storage.Assist the Biorepository Lead and Head of BSM as needed to manage the communication with Precision Medicine and the clinical study teams to address informed consent and IRB/EC questions… more
- Tris Pharma (Monmouth Junction, NJ)
- …other payer contracts, including redlining contract language, coordinating cross-functional review and approval workflows, and ensuring execution consistent with ... contact for IntegriChain (BPO partner), managing data file submissions, utilization reporting, rebate validation processes, and issue escalation to ensure… more
- University of California Agriculture and Natural Resources (Ventura, CA)
- …Posting Close Date: This job is open until filled. The first application review date will be 12/08/2025. Key Responsibilities: 45% Prepare samples for analysis. ... plots, work to coordinate applications, and maintain plots. 30% Collect and review data on established projects. 15% Ensure the laboratory equipment and supplies… more
- Novo Nordisk Inc. (Minneapolis, MN)
- …providers and IHNs; c) develops appropriate use of NNI products and greater utilization of its services d) supports and assists representatives and managers in ... sites; ensuring effective coordination and facilitation of studies to ensure timely review , initiation, and completion, as well as publication of study results.… more
- Eisai, Inc (New York, NY)
- …Executives to work with downstream regional payer accounts of the national payers. Review and analyze applicable data to make informed decisions on regional payer ... operate. Work closely with Medicaid Director and other cross-functional teams to review and analyze applicable data to make informed decisions on individual states… more
- Eisai, Inc (Nutley, NJ)
- …and proactively driving local solutions. Essential Functions Educate on utilization of promoted therapeutic products for specific indications; deliver clinical, ... territory business plan, aligned with overall business plan, and regularly review with management to ensure appropriate strategic, tactical components and call… more
- Novo Nordisk Inc. (Lubbock, TX)
- …appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
- Novo Nordisk Inc. (Irvine, CA)
- …appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
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