- Parexel (Springfield, IL)
- …Data Management Lead to join our team. If you have a passion for clinical research, strong project management skills, and a knack for data management , ... Science, OR equivalent industry experience. + 7+ years experience in pharmaceutical/biotech clinical data management / Biometrics ( clinical trial data… more
- Humana (Springfield, IL)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- Evolent (Springfield, IL)
- …a Clinical Reviewer, Nurse, you will routinely interact with leadership and management staff , other CR's ( Clinical Reviewers), providers, office staff ... Nurse, you will be a key member of the utilization management team. We can offer you...standards in the participating provider network and for other clinical staff . + Converses with medical office… more
- Evolent (Springfield, IL)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse… more
- Evolent (Springfield, IL)
- … Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Highmark Health (Springfield, IL)
- …per week (Tuesday-Thursday).** This role supports the full application product lifecycle for ** clinical and utilization management software** , with a ... and technical teams. They function as a pivotal bridge, translating high-level ** clinical and utilization management software** business needs into… more
- Evolent (Springfield, IL)
- …Cardiologist)** Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical ... appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and clinical staff to address complex cases and… more
- Evolent (Springfield, IL)
- …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Evolent (Springfield, IL)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- CVS Health (Springfield, IL)
- …and disposition. + Identifies and refers outlier cases (eg, Length of Stay) to clinical staff Identifies triggers for referral into Aetna's Case Management , ... with heart, each and every day. **Position Summary** As a Care Management Associate you will be supporting comprehensive coordination of medical services including… more
- Evolent (Springfield, IL)
- …Doing:** As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** . Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Evolent (Springfield, IL)
- …Doing:** Job Description As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Oracle (Springfield, IL)
- …user efficiencies, improved care coordination, reduced readmissions, increased access and utilization , and enhanced clinical workflows. * Training & Education: ... achieving health network goals. Key Responsibilities: * Client Consultation & Relationship Management : o Serve as the strategic lead for client engagements, working… more
- Highmark Health (Springfield, IL)
- …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... executing all facets of the Informatics project management process, leading multiple project managers, and potentially guiding, mentoring, or providing senior-level… more
- Oracle (Springfield, IL)
- …+ **Informatics and Strategy** : Work as intermediaries between IT professionals and clinical staff , ensuring that technological changes align with clinical ... providers, nurses, and pharmacists. This role requires a unique blend of clinical expertise, leadership, informatics, change management , and data science skills.… more
- Humana (Springfield, IL)
- …care industry, Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical ... put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D...with prior experience participating in teams focusing on quality management , utilization management , or similar… more
- Baylor Scott & White Health (Springfield, IL)
- …the design, execution, and communication of analytical output that identifies cost, utilization , and clinical trends across the organization. This role supports ... support of developing cost mitigation strategies that meet overall clinical and business needs. **_The pay range for this...audiences. + Manages and trains a team of analytics staff ; Responsible for organization, prioritization, and management … more
- Highmark Health (Springfield, IL)
- …developing, implementing, supporting, and optimizing the architectural strategy for **all clinical and utilization management applications** . Their ... cloud migration, and AI integration, extending this strategic oversight across **all clinical and utilization management applications** . This involves… more
- Humana (Springfield, IL)
- …corporate communications to be shared with senior leadership. + Supports trend management by conducting analysis of drug spend, utilization , and/or approval ... communicating with staff in different positions and all levels of management positions + Manages the Humana Michigan FIDE-SNP health plan relationship with our… more
- Veterans Affairs, Veterans Health Administration (Springfield, IL)
- …and routine treatment procedures. These operations are carried out with assistance from staff members from other clinical and support services that are ... supervised by their clinical service chiefs but provide a full range of...management is the goal for all Ambulatory care staff . Ensures adequate medical record documentation, organizes staff… more
