- Evolent (Boise, ID)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... clinical professionals. + A role that values innovation, continuous improvement, and clinical excellence. + **This position is 100% Remote and can be… more
- Molina Healthcare (Boise, ID)
- …4 weeks Monday-Thursday and Wed - Saturday._** **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and correct clinical ... decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical reviews of… more
- Prime Therapeutics (Boise, ID)
- …staff and/or pharmacists. + Escalates requests to Pharmacist when request requires extensive clinical review or denial. + Monitors telephone system to ensure ... our passion and drives every decision we make. **Job Posting Title** Clinical Pharmacy Technician/Call Center exp required- REMOTE **Job Description** Evaluates… more
- Prime Therapeutics (Boise, ID)
- …our passion and drives every decision we make. **Job Posting Title** Senior Director Clinical Account Management - Remote **Job Description** The Sr Director of ... request for proposals; account leadership during project implementations. + Review and assign account executive's book of business and...new ideas and work collaboratively to provide the highest quality of care and service to our members. If… more
- Molina Healthcare (Boise, ID)
- **EMERGENCY ROOM ADMISSIONS REVIEW NURSE** **_2 openings for 12 hour NIGHT SHIFT: 7:30PM (in the evening) - 08:30AM (in the morning) PACIFIC HOURS NON EXEMPT, 3 days ... HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- Molina Healthcare (Boise, ID)
- …RN license for the State(s) of employment **Preferred Education** Preferred field: Clinical Quality , Public Health or Healthcare. Nursing: Master's or higher ... and management of interventions (eg, removing barriers to care); preparation for Quality Improvement Compliance surveys; preparation and review of potential … more
- Molina Healthcare (Boise, ID)
- …team, National Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS review and results. + Works with the Manager ... **Job Description** **Job Summary** Molina's Quality Improvement Lead Overreader conducts oversight and audits...Performs the lead role of the HEDIS medical record review overreader/auditor which includes ongoing review of… more
- RELX INC (Boise, ID)
- …assist in maintaining alignment with established editorial standards. + Participating in the clinical review process by providing feedback on content produced by ... relevance of point-of-care and educational materials? Would you excel in creating high- quality , innovative educational content for clinical training? About our… more
- Fujifilm (Boise, ID)
- …where appropriate. + Participates in professional organizations. + Provides telephone and remote clinical support for customers, sales, and field service via ... **Position Overview** The Clinical Consultant, MI - I shall be responsible...the project, report configuration (CV), workflow analysis, end-to-end testing, remote or onsite training as well as go-live support… more
- EBSCO Information Services (Boise, ID)
- …high- quality content within specific content domain(s), applying both clinical knowledge/experience and the principles of evidence-based practice. The candidate ... than 2,700 people worldwide, with most embracing hybrid or remote work models. As an AI-enabled service leader, we...to help make an impact. **Your Opportunity** The Obstetric/Newborn Clinical Editor will be responsible for supporting the Section… more
- Evolent (Boise, ID)
- …Participates in the development and implementation of new strategies to make the clinical review process more efficient through people, processes, and technology ... to, supporting the execution of population health, value-based care, clinical quality and clinical operation...operations in a health plan environment The position is remote with 20% travel expected. **Technical Requirements:** We require… more
- Cardinal Health (Boise, ID)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... life-changing therapies to patients who need them-faster.** **_Job Summary_** The Manager, Clinical Operations provides management and clinical oversight to a… more
- Cardinal Health (Boise, ID)
- …of all program compliance activities, product training and adverse event/product quality complaint training. + Oversight of clinical training, coach, ... patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to… more
- Sharecare (Boise, ID)
- …supporting each individual through the lens of their personal health and making high- quality care more accessible and affordable for everyone. To learn more, visit ... for members in an appropriate, efficient, and cost-effective manner while ensuring high quality care. The RD colleague has responsibility for the provision of member… more
- Cardinal Health (Boise, ID)
- …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... in the future. + Maintain working knowledge of client-facing, clinical , and industry trends, and as well as providing...efficiency; reduce client expenses when possible while never sacrificing quality of care. + Urgently resolve, escalate, and own… more
- Molina Healthcare (Boise, ID)
- …care at the right place at the right time and assisting them to achieve optimal clinical , financial, and quality of life outcomes. + Responsible for clinical ... HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- Cardinal Health (Boise, ID)
- **What Real World Evidence and Clinical Research contributes to Cardinal Health** The _Scientist, Real World Evidence ( Clinical Research)_ , will have ... work this team is involved with is focused in Oncology. **_Location_** - Fully remote with minimal expectation of travel. Individuals in this role are able to work… more
- Prime Therapeutics (Boise, ID)
- …every decision we make. **Job Posting Title** Sr Director Rebate Analytics - Remote **Job Description** The Senior Director Rebate Analytics is responsible for the ... track relative to client offering. + Collaborate effectively with Prime's Clinical , Client Engagement, Product Development, Marketing, Operations, and other internal… more
- Molina Healthcare (Boise, ID)
- …Ideal candidates would have experience writing content in areas such as Clinical /Care Management, Provider Network, Quality and/or Behavioral Health within a ... a graphic artist and data analyst to create charts / illustrations * Review request for proposals (RFPs) and related documents furnished by the procuring agency;… more
- Molina Healthcare (Boise, ID)
- …Ideal candidates would have experience writing content in areas such as Clinical /Care Management, Provider Network, Quality and/or Behavioral Health within a ... and is responsible for preparing the executive summary for review by senior leadership. May serve as owner of...proposal team and subject matter experts (SMEs). Conducts peer review and coaching for junior and senior writers. Executes… more