- Humana (Providence, RI)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- Beth Israel Lahey Health (Westwood, MA)
- …systems to enter and access patient care information. 7. Participates in quality management and utilization review programs. 8. May coordinate the work of ... you're making a difference in people's lives.** Job Summary: The Pharmacy Direct Staff Pharmacist is responsible for the quality assurance of the provided pharmacy… more
- Edwards Lifesciences (Providence, RI)
- …post-case management , 3 Mensio management , Therapy Awareness program management and clinical education programs. + Implementing sales and educational ... and implementing growth strategies within focused accounts in partnership with Sales Management . + Developing clinical champions among current and potential… more
- Evolent (Providence, RI)
- … 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
- Evolent (Providence, RI)
- …independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. Acts as a member advocate by ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Beth Israel Lahey Health (Westwood, MA)
- …in people's lives.** The Medication Renewal Center Pharmacist provides comprehensive clinical pharmacy support in collaboration with the clinics of BILH in ... goal to improve operational efficiencies and deliver enhanced refill and medication management services. The pharmacist will practice under a scope of agreement to… more
- Edward M. Kennedy Community Health Center, Inc. (Milford, MA)
- …team is expanding across sites to support this growth. We are currently hiring a Clinical Care Manager based in Milford, MA. The Clinical Care Manager (CCM) ... provides, coordinates, and organizes evidence-based care management to chronic disease patients, especially to those who...and embrace the richness of the cultures of our staff and community. You are a good fit for… more
- Highmark Health (Providence, RI)
- …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
- Parexel (Providence, RI)
- …Data Management Lead to join our team. If you have a passion for clinical research, strong project management skills, and a knack for data management , ... Science, OR equivalent industry experience. + 7+ years experience in pharmaceutical/biotech clinical data management / Biometrics ( clinical trial data… more
- Evolent (Providence, RI)
- …Cardiologist)** Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical ... appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and clinical staff to address complex cases and… more
- Evolent (Providence, RI)
- …Doing:** As a Cardiology, Field Medical Director 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
- Evolent (Providence, RI)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Evolent (Providence, RI)
- …Doing:** As a Field Medical Director, Oncology, 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
- Evolent (Providence, RI)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Dana-Farber Cancer Institute (Attleboro, MA)
- …Director of Nursing is responsible for the planning, implementation and evaluation of clinical operations and personnel management of the assigned patient care ... Assures continuing education and role development of all nursing (RN, NP) and clinical support staff Demonstrates an understanding of the research process by… more
- Oracle (Providence, RI)
- …user efficiencies, improved care coordination, reduced readmissions, increased access and utilization , and enhanced clinical workflows. * Training & Education: ... achieving health network goals. Key Responsibilities: * Client Consultation & Relationship Management : o Serve as the strategic lead for client engagements, working… more
- Highmark Health (Providence, RI)
- …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... executing all facets of the Informatics project management process, leading multiple project managers, and potentially guiding, mentoring, or providing senior-level… more
- State of Massachusetts (Canton, MA)
- …* Oversee the recruitment, hiring, and onboarding of psychologists and other clinical staff , participating in interviews and candidate evaluations. * Prepare ... using standardized instruments. * Develop and implement treatment plans, designate clinical diagnoses, and oversee utilization review in accordance with… more
- Oracle (Providence, RI)
- …+ **Informatics and Strategy** : Work as intermediaries between IT professionals and clinical staff , ensuring that technological changes align with clinical ... providers, nurses, and pharmacists. This role requires a unique blend of clinical expertise, leadership, informatics, change management , and data science skills.… more
- Humana (Providence, RI)
- …care industry, Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical ... put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D...with prior experience participating in teams focusing on quality management , utilization management , or similar… more