- The Cigna Group (Franklin, TN)
- …departments of insurance, and similar accreditors/regulators for the performance of all utilization management (UM) programs across the enterprise . The CMO is ... areas of the organization and outcomes monitors focusing on potential over- and under- utilization of delegated services + Oversee clinical policy development via… more
- Intermountain Health (Murray, UT)
- …other partners (St. Luke's, IH NV, UHC PPO, 7day FU with Intermountain Behavioral Clinical program, Castell, Disease Management across the enterprise - like CKD, ... products. **Essential Job Duties:** + Stays abreast of industry trends and evaluates utilization , clinical and social determinates of health data to ensure… more
- Humana (Frankfort, KY)
- …measurable value. You are passionate about collaboration and partnering across the enterprise (eg, Clinical Operations, Markets, Care Management, Clinical ... and help us put health first** The Director of Utilization Management (UM) Cost of Care Strategy provides data-based... Operations and Market partners, ensuring connectivity into broader enterprise strategies and with broader clinical assets… more
- Hackensack Meridian Health (Holmdel, NJ)
- …and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for ... coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and serve as a leader of positive change. The Case Management Care Coordinator, Utilization Management is a member of the healthcare team and is responsible for ... coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care… more
- Hackensack Meridian Health (Hackensack, NJ)
- …healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for ... coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care… more
- Hackensack Meridian Health (Neptune, NJ)
- …and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for ... coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Shared Services Program Manager II Job Category: Administrative, HR, Business Professionals Department: Claims Data and Support Services Location: Los ... to support the safety net required to achieve that purpose. Job Summary The Enterprise Shared Services Program Manager II is responsible for leading and managing a… more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** **Director of Enterprise Data Engineering - Digital and Technology Partners - Remote - Req#3016788** The Director of Enterprise Data ... Engineering is a key part of the enterprise data & analytics leadership team. This role will...and data models to support the creation of operational, clinical , strategic, and research-focused analytics use cases. + Coordinate… more
- Vanderbilt University Medical Center (Nashville, TN)
- …strategic plan, budgets, resource allocation, operational plans, and policies for the Clinical Enterprise . * Identifies, allocates, and proposes resources to ... staff and faculty. * Establishes systems to share knowledge across the clinical enterprise . Communicates organizational information to ensure staff/leaders are… more
- CVS Health (Pittsburgh, PA)
- … management (UM) programs and the formulary/UM management systems for the enterprise . The role will support clinical workstream activities in meeting ... maintenance of the CVS Caremark's standard and client-modified formularies, utilization management programs/policies and assuring clinical appropriateness,… more
- Community Clinic Inc. (Silver Spring, MD)
- …terminology, clinical roles, and national healthcare organizations. + Knowledge of clinical quality measures and clinical decision support systems. + ... policies, and procedures as well as training materials for enterprise data utilization . + Provide subject matter... roles, and national healthcare organizations. + Knowledge of clinical quality measures and clinical decision… more
- HonorHealth (Scottsdale, AZ)
- …oversees the research coordination aspects of clinical operations supporting the clinical research enterprise at HRI including clinical research ... Oversee the clinical coordination operations in its entirety supporting the clinical research enterprise . This includes clinical trial support operations… more
- HSS (New York, NY)
- …and direct observation of nursing practice. The CES possesses mastery of clinical decision making, critical thinking, knowledge acquisition and dissemination, ... Mission, you too can be part of our transformation across the enterprise . Clinical Education Specialist (CES) 12pm-10pm TheClinical Education Specialistis… more
- HSS (New York, NY)
- …and direct observation of nursing practice. The CES possesses mastery of clinical decision making, critical thinking, knowledge acquisition and dissemination, ... our Mission, you too can be part of our transformation across the enterprise . Regional Clinical Education Specialist (CES)-Ambulatory Four (10) shifts weekdays… more
- Henry Ford Health System (Bingham Farms, MI)
- …quality of care provided by the primary care team. He/she works with utilization management reports, corporate data stores, and information services to optimize drug ... services, decrease waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental in guiding the further development… more
- Cedars-Sinai (CA)
- **Job Description** **Grow your career at Cedars-Sinai!** The Enterprise Information Services (EIS) team at Cedars-Sinai understands that true clinical ... " list, which highlights hospitals that have excelled in the utilization of electronic functionalities, telemedicine, digital imaging, artificial intelligence and… more
- Novo Nordisk (San Francisco, CA)
- …NN, other affiliates, and global. We're looking for individuals who are enterprise thinkers, inclusive leaders, and strong collaborators, as we embark on shaping ... and community thought-leaders in an assigned territory. The Rare Renal Clinical Account Manager will be principally responsible for driving disease awareness,… more
- Humana (Columbus, OH)
- …us put health first** Humana Healthy Horizons is seeking a Capture Lead, Clinical & Population Health Strategy, to lead initiatives developing and executing strategy ... across the organization, coordinating with Medicaid and Medicare leadership and clinical subject matter experts to synthesize, assess, and translate state… more
- The Cigna Group (Bloomfield, CT)
- …you crave an intellectually stimulating job that allows you to leverage your clinical expertise while developing new skills and improving the lives of others? Then ... look no further! As a Clinical Biochemical Genetics or Clinical Molecular Genetics...to help ensure patients receive proper care via evidence-based decision making. **What you'll enjoy about working here:** +… more