- CVS Health (Richmond, VA)
- … 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 (Richmond, VA)
- …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 (Richmond, VA)
- …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
- Elevance Health (Richmond, VA)
- …problem solving with providers, claims or service issues. Assists with development of utilization /care management policies and procedures. + Within the medical ... **The Transplant Nurse II** is responsible for providing case management and/or medical management (UM/UR) for members...on the team in preparation for advancement to the senior level. Primary duties may include, but are not… more
- HCA Healthcare (Richmond, VA)
- …IV inventory control, data collection, goal setting, managing Team Member, financial management , and checking the work of various aspects of technicians, performance ... duties in the IV Area, as requested by pharmacy management . **Specific responsibilities shall include, but not be limited...monthly inspections of the IV area for regulatory and accreditation standards of compliance. + Reviews narcotic records and… more