- CVS Health (Richmond, VA)
- …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
- CVS Health (Richmond, VA)
- …health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our Models of Care ... physical, behavioral and socioeconomic needs. * Partner closely with the Executive Director of Duals and other Duals Care Management leadership to collaborate across… more
- Evolent Health (Richmond, VA)
- …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 (Richmond, VA)
- …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 (Richmond, VA)
- …Prime's functional areas: Clinical Program Management, Utilization Management ( UM ), Formulary, GuidedHealth, Pharmaceutical Trade Relations, Pharmacy Audit, Clinical ... and process support for Prime National and Client Utilization Management ( UM ) programs, review of regulatory requirements and adherence for processes related… more