- Alameda Health System (Oakland, CA)
- …plans Role Overview: Alameda Health System is hiring! The Director of Utilization Management holds a critical role encompassing operational oversight, strategic ... hoc duties as needed. In essence, they orchestrate efficient utilization management to deliver high-quality patient care....in the classification. Lead and manage a team of utilization review professionals providing guidance, training, and… more
- Harbor Health Services, Inc. (Mattapan, MA)
- …for more than 580 participants. We are currently seeking a Director of Utilization Management & Quality Programs. Harbor Health offers an excellent, ... Reporting to the Senior Director of Health Plan Operations, the Director of Utilization Management and Quality Programs is responsible for the day-to-day… more
- Buckeye Community Health Plan (Thornville, OH)
- …functions for the business unit. Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. ... Performs medical review activities pertaining to utilization review...expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory,… more
- Christus Health (San Antonio, TX)
- …Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/ Utilization Management /appropriateness: Assess assigned patient population for ... This position provides expertise and leadership to insure effective resource management for patient care delivery (Conditions of Participation COP 482.30). Case… more
- Tris Pharma (Monmouth Junction, NJ)
- …of contracting, pricing governance, government compliance, and vendor management . The Director orchestrates complex cross-functional workflows, manages day-to-day ... other payer contracts, including redlining contract language, coordinating cross-functional review and approval workflows, and ensuring execution consistent with… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …including specimen identifiers and metadata, and ICF-associated permissions prior to utilization .Collaborate with Procurement to review contracts and ensure ... around rare diseases and immune disorders. We are currently seeking a Biosample Management Operations Intern from June 2026 - May 2027. This position will be… more
- Novo Nordisk Inc. (Minneapolis, MN)
- …policies, legal, regulatory, and compliance requirements Ensures effective administrative management of regional business as well as operational budgets Maintains ... as directed Records all activities within a customer response management system (eg VEEVA) and all expenses within Concur...c) develops appropriate use of NNI products and greater utilization of its services d) supports and assists representatives… more
- USAA (San Antonio, TX)
- …rules and regulations and use of regulatory reporting platforms ie Axiom, etc Utilization of financial management tools ie Oracle Cloud General Ledger (GL), ... Reporting Senior , you will serve as a key contributor in the preparation, review , and analysis of reports compiled for regulatory agencies to include the FR Y-9C,… more
- Novo Nordisk Inc. (Lubbock, TX)
- …adverse cardiovascular events. Our ambition is to advance broad cardiometabolic disease management by bringing exciting new therapies to market to improve patient ... productively and respectably challenge and influence target physicians' approach to patient management and adds value by sharing new information and unique insights… more
- Eisai, Inc (Boston, MA)
- …Executives to work with downstream regional payer accounts of the national payers. Review and analyze applicable data to make informed decisions on regional payer ... effectively implement those plans at local level. Keep senior management updated on all key issues at account(s) in...closely with Medicaid Director and other cross-functional teams to review and analyze applicable data to make informed decisions… more
- Novo Nordisk Inc. (Irvine, CA)
- …productively and respectably challenge and influence target physicians' approach to patient management and adds value by sharing new information and unique insights ... appropriate patients that would benefit in order to ensure early trial and utilization Generates advocacy for Novo Nordisk products and services by sharing approved… more
- Christus Health (Wake Village, TX)
- …chart peer review , case records review and utilization review as deemed necessary by management . Performs all other duties as assigned. Requirements: ... Education/Skills Masters level degree in speech language pathology is required. Basic Computer Knowledge Ability to communicate effectively, both verbally and in writing. Experience New graduate entry level or any amount of experience in speech therapy is… more
- Christus Health (Leary, TX)
- …chart peer review , case records review and utilization review as deemed necessary by management . Performs all other duties as assigned. Requirements: ... Education/Skills Masters level degree in Speech Language Pathology is required Basic computer knowledge Ability to communicate effectively, both verbally and written Experience New graduate entry level or any amount of experience in speech therapy is… more
- Christus Health (Red Lick, TX)
- …chart peer review , case records review and utilization review as deemed necessary by management . Performs all other duties as assigned. Requirements: ... Education/Skills Masters level degree in speech language pathology is required. Basic Computer Knowledge Ability to communicate effectively, both verbally and in writing. Experience New graduate entry level or any amount of experience in speech therapy is… more
- Interim HealthCare (Greenwood, IN)
- …Registered Nurse (RN) in home health or similar setting; previous case management / utilization review experience preferred. OASIS experience preferred. ... implementation and ongoing assessment of the patient's plan of care through the management of home health aides, LPNs, RNs, and other caregivers. Communicate patient… more
- Butterball (Calypso, NC)
- …maintaining safety culture and ensuring continuous improvement through the utilization of Butterball Operating System Solutions (BOSS). Supports and empowers ... tasks. Participates in HR activities such as hiring, terminations, performance management , goal setting, team member development, scheduling, etc. Enforces systems,… more
- Harford County Government Department of Public Works (Perryman, MD)
- …Duties: Supports the preparation of the annual budget and assists with the management of budgets, ensuring cost control and expenses are in alignment with the ... construction, etc. Compiles and prepares written and verbal reports for management and regulatory authorities Researches, prepares reports, and analyzes data on… more
- Fresenius Medical Care (Fayetteville, NC)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Care (Hayward, WI)
- …auditing activities. Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. Manages clinic financials ... including efficient utilization of supplies or equipment and regular profits and loss review . Responsible for all required network reporting and on-site state or… more
- Yale New Haven Health (Danbury, CT)
- …A Charge Nurse. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization , And Staff And Self Development As Outlined In Performance ... Review . Performs Other Duties As Assigned Or Directed To...Neuro Assessment Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient Demonstrates Skill And Understanding… more
