- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Physician Clinical Reviewer - GI- REMOTE **Job Description Summary** Key member of the ... clinical determinations cannot be made by the Initial Clinical Reviewer . + Discusses determinations with requesting...as needed to discuss cases and problems. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- Evolent Health (Columbus, OH)
- …matter expert in meetings, as assigned with practices and/or payers. + Perform all peer clinical review activities while located in a state or territory of the ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance… more
- CVS Health (Columbus, OH)
- …cost-effective outcomes. **Position Responsibilities:** + Through the use of clinical tools and information/data review , conducts comprehensive assessments ... strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and...networks and resources. + Crisis intervention skills + Managed care /utilization review experience + Case management and… more
- Sharecare, Inc. (Columbus, OH)
- …+ Applies clinical knowledge and skills to establish the most effective plan of care . Assesses member's nutritional needs, develops a nutrition plan ... orientation and to take the pre and post-test to review competency during orientation. Yearly competency test is required...committed individual who recognizes the impact of the health care delivery system on the clinical and… more
- Prime Therapeutics (Columbus, OH)
- …drives every decision we make. **Job Posting Title** Director, Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary** Responsible for ... new clients. Required to serve as a Medical Pharmacy clinical resource throughout the organization and support all ...new drug to market cost impact analyses for health plan clients + Manages Medical Pharmacy development needs for… more
- CVS Health (Columbus, OH)
- …optimal, cost-effective outcomes. **Assessment of Members:** Through the use of clinical tools and information/data review , conducts comprehensive assessments of ... the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member… more
- Humana (Columbus, OH)
- …changes. + Manages appeal process for delegate requires for changes to PAL or clinical policy. **Developing and overseeing the plan for MD speaker engagement in ... and manage the enterprise framework to facilitate and document consistent clinical decision making. This includes ensuring appropriate monitoring controls are in… more
- Cardinal Health (Columbus, OH)
- …group is expanding focused on generating data and insights through real-world clinical research. Research Operations and Clinical Specialty is responsible for ... providing quality, timely, granular and actionable data for selected operational and clinical metrics, as well as tracking and identifying trends for healthcare data… more
- Prime Therapeutics (Columbus, OH)
- …and other research applications and opportunities beneficial or of interest to the plan + Provide clinical guidance and support for client's Health Insurance ... business + Manage incoming requests for information from the plan regarding drug therapy, formulary and clinical ...include at least 5 years of experience in managed care or clinical pharmacy + Must be… more
- Prime Therapeutics (Columbus, OH)
- …and other research applications and opportunities beneficial or of interest to the plan + Provide clinical guidance and support for client's Health Insurance ... business + Manage incoming requests for information from the plan regarding drug therapy, formulary and clinical ...years of relevant work experience in a retail, hospital, clinical and/or managed care setting, including at… more
- Cardinal Health (Columbus, OH)
- …**_Gastroenterology (GI) Customer Success_** **_contributes to Cardinal Health_** The Clinical Manager for our Gastroenterology (GI) Customer Success team is ... responsible for leading the Customer Success Clinical function of PPS Analytics. This individual will be responsible for attaining specific objectives defined by the… more
- Ciena Healthcare (Westerville, OH)
- The **Director of Clinical Reimbursement** will organize, direct, and provide training in the RAI Process and clinical documentation. This position is ... staying current on state-specific quality incentives and reimbursement related to clinical documentation. This role provides strategic direction and analysis to the… more
- Cardinal Health (Columbus, OH)
- …mission is to empower community oncology practices to deliver patient-centered cancer care . Navista, a Cardinal Health company, is an oncology practice alliance ... passionate about helping oncology practices navigate the future. The Director, Clinical Research & Strategy executes innovative strategies for programs and products… more
- Cardinal Health (Columbus, OH)
- …of patient centered clinical products and/or services (ie value based care programs). During annual operating plan meetings and similar strategic ... mission is to empower community oncology practices to deliver patient-centered cancer care . Navista, a Cardinal Health company, is an oncology practice alliance… more
- Fresenius Medical Center (Gahanna, OH)
- …Assessments + Assist the registered dietitian in development and implementation of nutrition plan of care + Review monthly nutrition data with ... may under direct guidance of the Renal Dietitian: + Review of Renal Nutrition Basics and other applicable components...Provide input to the development and implementation of nutrition plan of care + Create nutrition related… more
- Cardinal Health (Columbus, OH)
- …**_Accountabilities in this role_** + Serve as internal subject matter expert on clinical products and services commonly used in care -at-home programs + Achieves ... 20 healthcare company that is reshaping the way high-acuity care is delivered across the country. **_What Category Management...including RN or LPN + 3 or more years' clinical experience in a hospital, home health, or hospital-at-home… more
- Organon & Co. (Columbus, OH)
- **Job Description** **The Position** The Women's Health Clinical Training Program Field Specialists (CTPFS) will execute and manage event types as designed within ... the Clinical Training Programs (CTPs), which provide an innovative way...was developed by Organon, LLC to ensure that health care professionals receive instructions and training on the procedures… more
- Cardinal Health (Columbus, OH)
- **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties support and expertise in ... calls and inbound call queue. + Meets regularly with Clinical Supervisor and/or Senior Nurse, Individualized Care ...Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings… more
- Cardinal Health (Columbus, OH)
- …integrated network preferred + Must possess experience with negotiating managed care /health plan contracts, administering and implementation of contracts. + ... mission is to empower community oncology practices to deliver patient-centered cancer care . Navista, a Cardinal Health company, is an oncology practice alliance… more
- Cardinal Health (Columbus, OH)
- **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties support and expertise in ... the areas of advice and consulting, research and patient care to internal business units and external customers. Individualized...Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings… more