• Utilization Management

    CVS Health (Frankfort, KY)
    …more personal, convenient and affordable. **Position Summary** This is a fully remote Utilization Review Clinical Consultant . **MUST RESIDE IN KENTUCKY** + ... skills to coordinate, document and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and is knowledgeable… more
    CVS Health (01/11/25)
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  • RN Clinical Consultant , Claims…

    Guardian Life (Frankfort, KY)
    **Position Summary** The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding ... medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions, limitations and duration impacting functional… more
    Guardian Life (12/20/24)
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  • Clinical Transformation Consultant

    Highmark Health (Frankfort, KY)
    …bachelor's degree + 5-7 years of experience in the healthcare industry (hospital clinical operations/ management , physician practice management or clinical ... that are required to accelerate the achievement of goals related to clinical operations excellence and optimal, sustained patient care (as manifested by patient… more
    Highmark Health (12/13/24)
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  • Medical Economics Consultant (Medicare)…

    Molina Healthcare (Lexington, KY)
    …the results to senior leadership. Responsible for consulting with network and clinical management on opportunities to improve our company's discount position ... analysis of markets and network initiatives. The Medical Economics Consultant manages conflicting priorities and multiple projects concurrently. Responsible for… more
    Molina Healthcare (01/13/25)
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