- Evolent Health (Columbus, OH)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Director , Utilization Management, you'll work with your managers, front line clinical team, and ... for our members, providers, and customers. **Collaboration Opportunities:** The Director , Utilization Management, will partner with a variety of different… more
- CVS Health (Columbus, OH)
- …and effective manner. * Actively participate in State Fair Hearings as needed. Understand UM and participate in UM front line work and appeals as needed ... illnesses through peer review and educational interventions.* Work with medical director teams focusing on inpatient care management, clinical coverage review,… more
- Highmark Health (Columbus, OH)
- …in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, ... overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures to… more