- CVS Health (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- …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 (Washington, DC)
- …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