- Magellan Health Services (Boise, ID)
- …minimal supervision. Project management skills and demonstrated experience. General Job Information Title Quality Clinical Reviewer ( Remote - Must live ... and external reporting. Interacts with multiple stakeholders internally and externally. Provides clinical reviews of Quality of Care (QOC) and Critical/Adverse… more
- Molina Healthcare (ID)
- …overturn rates. * Provides strategic leadership for both pre-pay and post-pay clinical review programs to grow overpayment identification, drive savings results, ... experience, position has oversight for creation, publication, and maintenance of DRG Validation clinical policies to support Clinical review program and… more
- Prime Therapeutics (Boise, ID)
- …passion and drives every decision we make. **Job Posting Title** Director, Clinical Product Development/RPh required- REMOTE **Job Description** The Clinical ... of designated clinical product domain + Monitor the performance of clinical products and implement continuous quality improvement plans to ensure the… more
- Prime Therapeutics (Boise, ID)
- …fuels our passion and drives every decision we make. **Job Posting Title** Director Clinical Account Services - Remote Nevada **Job Description Summary** Plays a ... key role in various clinical pharmacy accounts: overseeing the overall clinical ...Activities address impact on customers, operations, program integrity, pricing, quality and satisfaction. Develops and tracks appropriate metrics that… more
- Prime Therapeutics (Boise, ID)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Clinical Program Manager - Remote **Job Description** The Clinical Program ... Manager is responsible for the management of all client specific clinical programs and drug strategy recommendations including drug formulary, Utilization Management… more
- Prime Therapeutics (Boise, ID)
- …fuels our passion and drives every decision we make. **Job Posting Title** Specialty Clinical Program Director II - Remote **Job Description** The Specialty ... Clinical Program Director leads the overall clinical strategy, portfolio of clinical solutions, outcomes...may vary by 8% depending on applicant location. To review our Benefits, Incentives and Additional Compensation, visit our… more
- Prime Therapeutics (Boise, ID)
- … clinical research and analytics that improve medical cost savings and provide clinical quality initiatives + Manages current clients in all Medical Pharmacy ... and drives every decision we make. **Job Posting Title** Dir, Specialty Clinical Solutions/Medical pharmacy exp required- REMOTE **Job Description** + Supports… more
- Magellan Health Services (Boise, ID)
- …facilities, develops discharge plans and oversee their implementation. + Performs quality clinical reviews while educating and making appropriate interventions ... care. General Job Information Title Care Manager (SUD utilization review preferred) - REMOTE USA Grade 24...REMOTE USA Grade 24 Work Experience - Required Clinical Work Experience - Preferred Education - Required Associate… 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 ... objectives of the care enhancement program by ** ** providing high quality telephonic support in an appropriate, efficient and cost-effective manner while ensuring… more
- Molina Healthcare (ID)
- …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 ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- R1 RCM (Boise, ID)
- The Inpatient Coding Quality Reviewer will be responsible for...+ Audits medical records as defined in the coding quality review plan. + Review ... to the coder involved on a timely basis. The Reviewer provides expert coding advice to coding staff and...coding educational topics to the Regional Manager, IP Coding Quality . This role will report to the Regional Manager… more
- Takeda Pharmaceuticals (Boise, ID)
- … Operations Program Lead(s): + Oversee the execution of studies in assigned clinical program(s) in compliance with quality standards (including ICH GCP, local ... and empower you to shine? Join us as a Clinical Operations Manager based remotely reporting to the ...of the Operational Strategy in preparation for Operational Strategy Review ; focus on ensuring accurate assumptions are applied and… more
- Takeda Pharmaceuticals (Boise, ID)
- …by these new activities and ways of working. **Additional Activities:** + Assists with quality review of above activities performed by a vendor, as needed. + ... setup, data transfer/ review and support downstream transformation and analysis. The Clinical Data Sciences comprises of the Clinical Data Engineering (CDE)… more
- Cardinal Health (Boise, ID)
- …reside nationwide) **Responsibilities** + **Regulatory Submissions & Documentation** + Preparation, review , and manage the submission of regulatory, clinical ... trial designs, product development, and commercialization. + Provide regulatory input and review or preparation of clinical trial protocols, labeling, meeting… more
- Takeda Pharmaceuticals (Boise, ID)
- …into commercial and access/reimbursement activities and documents. + Prepare and/or review clinical and outcomes research protocols, statistical analysis plans ... GEO, this role informs and contributes to product strategies, clinical development plans and leads the development and execution...COAs + Compliance with all policies and regulations for quality and disclosure + Accountable for product annual plan… more
- Takeda Pharmaceuticals (Boise, ID)
- …compliance with own Learning Curricula, corporate and/or GxP requirements + Assists with quality review of above activities performed by a vendor, as needed ... clinical trials and to the delivery of high quality in a timely manner, which is eventually used...or Python certification This position is currently classified as " remote " in accordance with Takeda's Hybrid and Remote… more
- Takeda Pharmaceuticals (Boise, ID)
- …Inspection and Audit requests pertaining to their program + Conduct sample quality review of outsourced activities including SAE Reconciliation, eTMF filling, ... Join Takeda as an Associate Director, Global Patient Safety Clinical Operations in Cambridge, MA, where you will provide...SAE Forms and completion instructions + Review and create Study level documents including Study Management… more
- Takeda Pharmaceuticals (Boise, ID)
- …and executes a labeling implementation plan to incorporate new scientific, safety and clinical data, as well as Health Authority responses / feedback into CCDS, USPI ... support to Local Affiliates for responses to health authorities requests, review of local labeling exceptions and alignment deferrals, etc. Escalation Process… 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
- Highmark Health (Boise, ID)
- **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote - Part Time - Weekends Required.** This job implements the effective utilization ... management strategies including: review of appropriateness of health care services, application of...a Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes the delivery of health… more