Receive phone calls from prior authorization pharmacy techs and/or providers for clinical information. Interpret clinical guideline criteria, and render/review coverage determination for prior authorization cases. Gather complex clinical information, coverage policy and criteria information and work...
The essential functions of a Pharmacists in Prior Authorization are reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment. This position is for a Clinical Pharmacist working in the Prior Authorizat...
The Project Manager will be based on the construction project site. Participate with project team and preconstruction services in development of a Project Chart of Accounts. Coordinate with Project Superintendent in development of a project site logistics plan. Clayco specializes in the "art and sci...
We seek a highly motivated and detail-oriented Product Operations Manager to join our dynamic team. Collaborate with cross-functional teams, including Product Management, Engineering, Design, Marketing, and Sales, to develop and execute product operations strategies. Monitor key performance indicato...
In the Medical Director role you will provide oversight for medical policy implementation. The Medical Director will act as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams. You will participa...
As a CRA you will be joining the world’s largest & most comprehensive clinical research organisation, powered by healthcare intelligence. Primary interfaces: Provider Functional Manager, Clinical Trial Assistant, Local Trial Manager and Central Study Team for assigned clinical trials. Have a minimum...
We are seeking a Director - Engineering/Construction to join our Engineering department. Low-cost Medical / Dental / Vision Insurance. ...
Senior Project Manager, this person will manage end to end project cycles, including coordinating the efforts of the JD Group Design team, Project team and third party contractors. Prior project Management experience and ability to manage multiple, simultaneous projects across a number of group fasc...
Associate Medical Director Behavioral Health or UM Medical Director. As a member of the Utilization Management team, our Associate Medical Director Behavioral Health and UM Medical Directors provides leadership, and clinical oversight for behavioral health operations across all lines of business wit...
Responsible for the supervision of clinical staff and the maintenance of compliant clinical documentation under federal, state and local regulations and accreditation standards. Evaluates clinical employees in annual performance including effective clinical acumen, professional development and evalu...
About The Job Dudek is seeking a project manager to manage and coordinate the siting review and compliance monitoring activities of energy facilities under the Washington, Energy Facility Site Evaluation Council's (EFSEC) jurisdiction and Oregon, Energy Facility Site Council's (EFSC). Candidates tha...
Responsible for the supervision of clinical staff and the maintenance of compliant clinical documentation under federal, state and local regulations and accreditation standards. Evaluates clinical employees in annual performance including effective clinical acumen, professional development and evalu...
Through collaboration with your General Manager and/or Assistant General Manager, you will teach and coach behaviors to Leads, Experts and Brand Associates to cultivate a high performing team to deliver a best-in-class experience to our customers. As an Assistant Manager, you set the tone for the st...
Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Pain Management) that can be remote based, work from home. The Medical Director (Pain Management) will be a Subject Matter Expert (SME) with a background in Pain Management specialty, including post-graduate direct pati...
The Project Manager is responsible for the successful execution of the life cycle of a range of AI-Data projects, through the utilization of expertise and technical skills to manage project budgets, timelines, and quality requirements. The Project Manager is a results-driven and innovative project l...
Assistant Project Manager to support the implementation of project goals as directed by the project managers. Responsibilities include but are not limited to:-Project Manager Support: Assist project managers and Superintendents in achieving project goals. This role involves overseeing project goals...
Teach and mentor residents, fellows, and medical students. ...
This is a great opportunity for a Project Manager to join Proofpoint and help with our Core Financial initiatives. The Project Manager will have the ability to "think big", be creative and have fun while ensuring change is adopted over the long term. The PM will help to optimize the Core Financial p...
The Business Operations Manager oversees daily operations to ensure goals are achieved in a Home Health Agency. This role is responsible for the non-clinical aspects of the day-to-day operations in an agency including directing all business personnel in the areas of billing, patient and intake sched...
The Hospice Registered Nurse Clinical Manager is responsible for ensuring that care and services are delivered appropriately and for the supervision of clinical personnel. The Hospice Registered Nurse Clinical Manager is responsible for ensuring that patient care is coordinated and managed appropria...
This position will require the skillset of an experienced project manager who has successfully delivered large scale, multi-phased system implementations with multiple work streams, numerous different types of stakeholders and the ability to comfortably deliver updates and relay information to vendo...
The Medical Director (MD) for Aetna One Advocacy is responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent responsive medical care. The MD is a critical medical/business leader resource for ex...
The Clinical Program Manager Telehealth leads the development of standardized Telehealth clinical protocols across an assigned region (or multiple regions) in collaboration with system and regional Telehealth Administrative, Physician and Technical leaders. Clinical Program Manager RN *Remote*. Coll...
QuidelOrtho unites the strengths of Quidel Corporation and Ortho Clinical Diagnostics, creating a world-leading in vitro diagnostics company with award-winning expertise in immunoassay and molecular testing, clinical chemistry and transfusion medicine. Channel Sales Manager for the California & Paci...
To that end the offices are recruiting for an experienced and knowledgeable policy and project manager to oversee the legislature’s work in 2024 and 2025 on this critical public policy challenge. The ideal candidate will have knowledge of multi-modal transportation systems, current and potential ong...