- CVS Health (Scottsdale, AZ)
- …PBM clinical programs, including formulary development, Pharmacy & Therapeutics Committee, utilization management , and accreditation (eg, URAC, NCQA). ... personal, convenient and affordable. **Position Summary** The VP & Senior Legal Counsel for CVS Caremark is responsible for...clinical programs and Aetna pharmacy benefit. The VP & Senior Legal Counsel will act as a subject matter… more
- CVS Health (Phoenix, AZ)
- … in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds to ... programs and commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy revisions/reviews. - Directors… more
- Evolent Health (Phoenix, AZ)
- …selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director. ... Reviewer you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Evolent Health (Phoenix, AZ)
- …Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Banner Health (Mesa, AZ)
- …the operations of the unit to ensure smooth and efficient patient care management and resource utilization . 2. Leads change by developing, implementing and ... for innovative care including: Certified Primary Stroke Center - Acute Chest Pain accreditation - ACS Trauma Level II (Arizona State Trauma Level I) As an… more
- Banner Health (Phoenix, AZ)
- …the patient's plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating ... and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Acts in a leadership function to… more