- Highmark Health (Providence, RI)
- …weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of ... consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable… more
- Masonicare (Colchester, CT)
- …with administration). + Conducts clinical record reviews to assess the appropriateness of care plan, the utilization of services and to ensure complete ... RN Hospice Clinical Manager (Weekend Schedule) Job Location: Colchester, Connecticut RN...planning, organization, direction, evaluation and safe delivery of high-quality care to adult, geriatric, pediatric, and neonatal clients in… more
- Prime Therapeutics (Providence, RI)
- …hoc reports are provided accurately and on time. + Supports the State Drug Utilization Review Boards and Pharmacy and Therapeutics (P&T) Committee. Potential pay ... every decision we make. **Job Posting Title** Pharmacist Account Manager - New York Remote **Job Description** + Leads...may vary by 8% depending on applicant location. To review our Benefits, Incentives and Additional Compensation, visit our… more
- Evolent (Providence, RI)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...for the culture. **What You'll Be Doing:** **Provider Engagement Manager - Oncology** We are looking for the next… more
- South County Hospital (Wakefield, RI)
- …teams, and home care . The goal is to optimize patient care transitions thereby reducing unnecessary utilization of services and decrease the ... The Transitional Care Coordinator (TCC) coordinates seamless care ...Performs all other duties as assigned by Case Management Manager . The TCC will demonstrate careful professional and clinical… more
- Hartford HealthCare (Dayville, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and chemical dependency services. Through our multi-site network of care , we constantly strive to meet its mission in...oversight of daily operations in the absence of Program Manager . Key responsibilities of Lead Behavioral Health Clinician: *… more
- Hartford HealthCare (Mansfield Center, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and chemical dependency services. Through our multi-site network of care , we constantly strive to meet its mission in...oversight of daily operations in the absence of Program Manager . Key responsibilities of Lead Behavioral Health Clinician: *… more
- Hartford HealthCare (Groton, CT)
- …which may include staff scheduling, scheduling clinical activities, program development, utilization review , case load assignment, and attending meetings as ... and chemical dependency services. Through our multi-site network of care , we constantly strive to meet its mission in...oversight of daily operations in the absence of Program Manager . Key responsibilities of Lead Behavioral Health Clinician: *… more
- United Therapeutics (Providence, RI)
- …building effective models that support data driven decisions + Facilitate quarterly data review with Contract Manager / National Account Directors to evaluate ... with superior financial performance and our communities with earth-sensitive energy utilization . Our company was founded by an entrepreneur whose daughter was… more
- Prime Therapeutics (Providence, RI)
- …licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations, etc); compile ... of interest or other cyclical compliance processes, or implementing a regular review cadence for standard operating procedures (SOP) and policies + Research and… more
- Cardinal Health (Providence, RI)
- …and effective coordination of Cardinal Health's pharmacy operations that service acute care hospitals, hospital retail customers, ambulatory care and alternate ... customized pharmacy program solutions that reduce costs and improve patient care quality for hospitals, health systems and other integrated healthcare providers… more
- University of Connecticut (UConn) (Storrs, CT)
- …of Director, Psychiatric Medication (Services Student Clinical Mental Health Services Manager ). Provides clinical leadership for staff and faculty working with ... student populations, clinical and diagnostic assessment, psychotherapy, emergency care , consultation, and educational outreach to the University community regarding… more
- Northeast Family Services (Warwick, RI)
- …quality assurance team, the Administrative QA Reporting Associate will support the QA Manager and assist in running, tracking, and compiling reports for the QA and ... MA, NH, or NY. Responsibilities: + Assist the QA Manager with running daily, weekly, and monthly reports. +...stakeholders for reporting clarification and accuracy + Help compile, review , and quality check reports + Provide a high… more
- Prime Therapeutics (Providence, RI)
- …develop pricing in response to moderate to complex RFP's + Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing ... depth perception and ability to adjust focus **Reporting Structure** + Reports to Manager or Director in the Finance Department Potential pay for this position… more
- CSL Plasma (Johnston, RI)
- …to ensure efficient plasma collections. You will report to the Center Manager . **The Role** + In compliance with Standard Operating Procedures (SOPs), supervise ... and donor flow. Monitor time card reporting procedures, attendance, and utilization of overtime. + Conduct error investigations and develop recommendations for… more