- Merck & Co. (North Wales, PA)
- …identified growth opportunities supported by vaccine launches and through increased utilization of our inline vaccines. The Contracting and Distribution Strategies ... Physician Organization, Buying Groups, Health Systems, Medical Groups, Individual Health Care Provider Offices, the CDC, VA, DoD, and other Public Health… more
- Merck & Co. (North Wales, PA)
- …individuals dedicated to advancing our company's contribution to global medical innovation by leveraging information and technology.-One of the key priorities for ... our Company is a significant focus-on Data and its utilization as a Strategic asset to drive insights-driven decisions. The opportunity to accelerate our time to… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- Join a Legacy of Innovation 110 Years and Counting!Daiichi Sankyo Group is dedicated to the creation and supply of innovative pharmaceutical therapies to improve ... standards of care and address diversified, unmet medical needs of people...around the world draw upon a rich legacy of innovation and a robust pipeline of promising new medicines… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- Join a Legacy of Innovation 110 Years and Counting!Daiichi Sankyo Group is dedicated to the creation and supply of innovative pharmaceutical therapies to improve ... standards of care and address diversified, unmet medical needs of people...around the world draw upon a rich legacy of innovation and a robust pipeline of promising new medicines… more
- Novo Nordisk Inc. (Los Angeles, CA)
- …and partners with groups across NAO, Research & Early Development, Development, innovation hubs across NN, other affiliates, and global. We're looking for ... and support offerings, and activate patients and caregivers in their own care . This is accomplished by engaging with patients and caregivers one-on-one and… more
- Novo Nordisk Inc. (Minneapolis, MN)
- …and partners with groups across NAO, Research & Early Development, Development, innovation hubs across NN, other affiliates, and global. We're looking for ... for developing and maintaining relationships with physicians, nurses, and other health care personnel as relevant for the commercialization of rare renal medications… more
- Merck & Co. (North Wales, PA)
- …delivering novel solutions and precision medicine to transform the standard of care for Immune-Mediated Diseases.- Our most advanced investigational product is a ... resources and profitability targets. Responsible for leading team through financial review cycles.Team Leadership: Build and lead a high-performing team, providing… more
- Merck & Co. (Rahway, NJ)
- …AI, machine learning, predictive coding, etc.) to improve technology utilization and operational efficiencyEvaluate new vendors, suppliers, and solutions to ... strategy and framework, including e-discovery, legal hold, and information review and preservation activitiesEnsure appropriate security for official records and… more
- HonorHealth (Scottsdale, AZ)
- …across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary Reviews and monitors utilization of health care services with the goal of maintaining ... high quality cost-effective care . Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient… more
- Covenant Health (Nashua, NH)
- … care team. + Annual goals are achieved. + Attends pertinent case management/ utilization review programs to maintain current knowledge of UR practices. + Acts ... services and Outpatients in a Bed. Identifies delays in care . Documents and communicates findings with the care...+ Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all… more
- Actalent (Omaha, NE)
- …in medical review or utilization management. + Knowledge of utilization review , Medicare, utilization management, and EMR systems. Additional Skills ... Job Title: Utilization Management NurseJob Description We are seeking a...preauthorization processing. This role involves accurate and timely medical review of claims, preauthorizations, and customer service inquiries. You… more
- Stanford Health Care (Palo Alto, CA)
- …: Examine patient medical records to ensure the necessity and appropriateness of care provided. 3. Utilization Review : Conduct thorough utilization ... for this role. **This is a hybrid Stanford Health Care job.** **A Brief Overview** The Utilization ...utilization management principles. + Experience in case management, utilization review , or related healthcare roles. +… more
- Travelers Insurance Company (Buffalo, NY)
- …**What Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for ... **Who Are We?** Taking care of our customers, our communities and each...to the compensable injury and for adhering to multi-jurisdictional Utilization Review criteria. **What Will You Do?**… more
- WellSpan Health (York, PA)
- …in payor denials and appeals. + Serves as point of contact for System acute care utilization review issues and resolutions with payers. Collaborates with ... + Oversees the utilization management process for preauthorization, concurrent review , denials and appeals for System acute care facilities. +… more
- Actalent (Doral, FL)
- … + Utilization management + Concurrent review + Utilization review + Prior authorization + Health care + Medicaid + Medicare + Milliman commercial ... Utilization Management Nurse Job Description The role of...and coordination across settings, identifying member needs, planning for care , monitoring the efficacy of interventions, and advocating to… more
- Geisinger (Danville, PA)
- …key role in ensuring information is released to payers and physician level review . Frequently works with highly sensitive and confidential information. Job Duties + ... a resource to departmental staff regarding insurance contacts. + Maintains Utilization management SharePoint site to reflect updated payor information. +… more
- Actalent (Orlando, FL)
- …claims and preauthorization processing - Responsible for accurate and timely medical review of claims and preauthorization's - Responsible for accurate and timely ... medical review of customer service inquirers about claims and preauthorization's...directors and pharmacists to ensure medically appropriate, high-quality, cost-effective care , promote positive member outcomes, effective use or resources,… more
- HonorHealth (Scottsdale, AZ)
- …Required Experience 5 years in healthcare with experience in pre-certification Required 3 years experience in utilization review , medical management Required ... meaningful? At HonorHealth, you'll be part of a team, creating a multi-dimensional care experience for our patients. You'll have opportunities to make a difference.… more
- Stanford Health Care (Palo Alto, CA)
- … Management: Avoidable Delay Identification, Intervention & Tracking, Utilization Review , Medical Necessity Review , Care Plan Progression, Pre-Admission ... to be part of our legacy of hope and innovation , we encourage you to take the first step...facets of a patient's admission/discharge or outpatient visit/follow-up; performing utilization review activities, including review … more
- Nuvance Health (Danbury, CT)
- …Develop and implement a comprehensive, patient-centric vision and strategy for system-wide care coordination, encompassing utilization review (UR), denials ... for providing strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff… more
