- CVS Health (Phoenix, AZ)
- …in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment ... in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment… more
- Evolent Health (Phoenix, AZ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Senior Director , Partner Operations** The Senior Director , Partner Operations serves as ... the go-to expert on client priorities. **Collaboration Opportunities** The Senior Director , Partner Operations role also collaborates with internal teams as… more
- Evolent Health (Phoenix, AZ)
- …Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management team. We can offer ... Evolent Health is looking for a Behavioral Health Medical Director to be a member of the Evolent clinical...health plan medical policies, and appropriate Care Management and UM goals and objectives + Population health - collaborative… more
- Evolent Health (Phoenix, AZ)
- …a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to ... medical, pharmacy and ancillary claims data, membership data, clinical operational data ( UM & CM), or other healthcare data- **Required.** + Familiarity with Power… more
- Prime Therapeutics (Phoenix, AZ)
- …Prime's functional areas: Clinical Program Management, Utilization Management ( UM ), Formulary, GuidedHealth, Pharmaceutical Trade Relations, Pharmacy Audit, Provider ... and process support for Prime National and Client Utilization Management ( UM ) programs, review of regulatory requirements and adherence for processes related… more
- HonorHealth (Scottsdale, AZ)
- …department policies and procedures. The Manager will provide oversight for all PA/ UM staff, and Accreditation Specialist in the department. In addition, this role ... productivity. Performs evaluations and feedback for staff and works with Director to identify appropriate program enhancements based on evaluations, quality results,… more