Pharmacy Utilization Lead (Non-Clinical / UM Systems)
AffirmedRx
AffirmedRx is seeking a detail-oriented non-clinical administrator to lead pharmacy utilization management program administration. You will process prior authorization requests, ensure workflow compliance, and support regulatory adherence. As a subject matter expert, you will coordinate workflows, provide training, oversee quality, resolve escalations, and serve as a super-user for UM technology to drive process improvements. #J-18808-Ljbffr AffirmedRx
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...EMPASS 2.0 Empass is building the operating system for modern healthcare — one platform spanning clinical care (CareConnect), pharmacy (EmpassRx), diagnostics (EmpassDx), home... ...single design authority all 6 PMs and Eng Leads work with. The Impact You'll Make: Nearly 7...Suggested$100k - $130k
...those who need it most. The Utilization Management (UM) team plays a vital role in... ...clinicians who combine clinical expertise with data-driven... ...with CMS guidelines. As the Lead RN, Utilization Management,... ...We believe the healthcare system is broken, so we've created...SuggestedWork experience placementWork at officeRemote workFlexible hours- ...payer policies. Evaluate clinical documentation, identify... ..., and standardize UM/UR workflows, best practices... ...leadership to optimize utilization management, patient... ...coordinating workflows, or leading process improvement.... ...have access to the Omega systems set forth in "Standard...SuggestedFull timeWork at officeRemote workHome officeMonday to FridayWeekend work
$39.4 - $53 per hour
...Ensemble! Ensemble is a leading provider of technology... ...solutions for health systems, including hospitals... ...Position Overview The Lead Utilization Review RN is a key... ...financial, quality, and clinical performance of the... ...communication regarding non-coverage of benefits to...SuggestedWork at officeLocal areaRemote work- ...Algonquin Power & Utilities Corp. (AQN), parent company of Liberty, is... ...Purpose The SAP Functional Lead serves as Liberty's SAP business... ..., operational challenges, and system-related needs. Facilitate... ...data impacts to technical and non-technical audiences. Experience...Full timeFlexible hours
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Allied Health --> Clinical LabsNew York • ID: 1168632_RR00... ...is a fully integrated health system that consistently achieves the... ...to join our team as a Lead Clinical Laboratory Technologist... ...requirements for PPE and the utilization of engineering controls to maintain...Full timeShift work- ...Job Description Job Description Lead Clinical Automation & AI Systems Engineer Department: Clinical Operations & Technology Engineering Reports to: Founders & Associate Director of Clinical Operations Location: Midtown Manhattan, NYC (Hybrid preferred...Remote workDay shift
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Lead Medical Support Assistant (Clinical Contact Center) Department: Department of Veterans Affairs Location: Anywhere... ...refill requests Managing patient systems to verify and validate accuracy and... ...Assists the unit with complex and non-standard procedures, including...Remote work$192k - $278k
Manage end-to-end water utility deal origination and execution pipeline, directing negotiations... ...acquisition and technical due diligence leading mission-critical utility infrastructure... ...negotiation for water supply or utility system construction.Preferred qualifications:8...Contract work- ...every discrepancy has a deadline.The Work:Lead Tier 1 and Tier 2 billing variance... ...and special billing scenarios to identify systemic configuration or code issues.Present variance... ...experience with Oracle CC&B and/or Oracle Utilities CCS / C2M with a deep focus on billing and...Work experience placementLive inWork at officeLocal area
- ...about Accenture's Oracle practice (.)You Are:A senior Oracle Utilities Integration Lead who brings both the architectural vision and the hands-on... ...how core solution changes ripple across integrating systems — and you can communicate those impacts clearly to third-party...Work experience placementLive inWork at officeLocal areaRemote work
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...digital solutions to support clinical trials. Celebrating... ...offers industry-leading expertise, analytics-powered... ...serve as our Consulting & System Integrator (C&SI)... ...SIs operate, including utilization targets, consultant skill... ...and many of Medidata's non-sales positions are eligible...Work at officeLocal areaRemote workFlexible hours$4,500 - $5,500 per month
...that stops someone mid-scroll at midnight got there because the system behind it worked. Someone has to read the numbers, kill what is... ...You will read data one hour and unblock a stuck edit the next. Non-Negotiable Requirements Proven experience running a team or a repeatable...Night shift- ...requirements of the quality systems manual, operating and... ...instructions. Lead and/or train work group... ...to determine accuracy utilizing rulers, templates, or other... ..., equipment, tools and non-standard assembly work... ...Assistance Program Onsite Clinic - Free medical visits Safety...Temporary workShift workNight shiftWeekend work
$136k - $180k
...maintain outbound data flows for downstream systems (Oracle FDI) Data Integration &... ...annual discretionary incentive programs, non-annual sales incentive plans, or other non... ...retire with dignity, today we're a market-leading retirement company fueled by world-class...Work experience placementWork at office- BronxCare Health System is seeking a Coordinator for Behavioral Health Utilization Management (BH-UMC). Responsible for reviewing and monitoring patients admitted for psychiatric or substance abuse treatment, the ideal candidate will have expertise in Utilization Management...
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...patients can access Agios therapies within the pharmacy benefit by navigating payer coverage and... ...engagement; provide compliant, non-promotional access information. Identifyaccess... ...Document activities and outcomes in required systems; protect patient information...Remote jobTemporary workWork at officeFlexible hours- AnewHealth is one of the nation’s leading pharmacy care management companies... ..., pharmacy operations, clinical documentation, quality assurance... ...within company systems. Reviews medication-related... .... Supports prospective drug utilization review and other pharmacist...Full timeTemporary workLocal areaRemote workFlexible hours
- United Site Services is hiring for a Utility Technician to operate various Non-CDL vehicles and support field operations. Duties include servicing portable restrooms, tanks, and containers, following routing information, and maintaining logs in compliance with regulations...
- ...for Drexel degree programs, certification, and non‑certification programs. Drexel also participates... ..., please review Drexel's Benefits Brochure. Lead Course Subject Matter Expert - Leadership in Literacy Science & Systems Change Apply now Job no: 506300 Work type: Part...Part timeWork at officeImmediate startRemote workFlexible hours
- ...of new/existing programs and systems for business or patient care needs... ...corrective actions. Leads technical implementation efforts... ...multidisciplinary teams. Provides training to clinical end users. Essential Job... .... Provides supports during non-working hours to ensure the...
- ...of 7 years of hands on work experience in clinical data management within a pharmaceutical,... ...least one Electronic Data Capture (EDC) system ( Medidata Rave, Veeva Vault EDC ) is REQUIRED... ..., WHO Drug ). Minimum of 3+ years of lead or project management experience in clinical...16 hoursFull timeWork experience placementWork at officeRemote work
- ...JOB SUMMARY We are seeking a Lead Clinical Data Manager to serve as the primary Data Management resource on one or more clinical studies... ...in a scientific discipline, nursing, business, or information systems, with 7-10+ years of clinical data management experience,...Flexible hours
- ...We are partnering with a leading life sciences organisation to recruit multiple Lead Clinical Data Managers to support clinical trials across the full study lifecycle... ...advantageous. Hands‑on experience with EDC systems, UAT, data review, query management and reconciliation...Remote work
- Acentra Health is seeking a Clinical Supervisor (RN) to oversee Utilization Management activities and ensure contract requirements are met with high standards... ...), 2+ years in healthcare management, and 5+ years in a lead utilization/quality role. #J-18808-Ljbffr AcentraContract work
- ...relationships to prioritize clinical quality and patient experience... ...millions. About the Role The Lead Advocate is a Licensed Mental... ...document in electronic health systems and utilize desktop applications for... ...including those who have taken non-traditional paths to acquire...Contract workTemporary workFor contractorsRemote work
- Ensemble Health Partners is seeking a Lead Utilization Review RN to support medical necessity determinations and discharge planning, ensuring... ...nurses, coding professionals, and hospital staff to optimize clinical and financial outcomes. Qualified candidates will have an RN...
- ...Manager, and Director. Utilizes the nursing process to... ...diversity. Supervises non-professional personnel... ...comprehensive range of services or clinical care associated with... ...cards are entered into system prior to the start of... ...& In-House Employee Pharmacy* Dental Plan* Vision...Full timeTemporary workPart timeFlexible hours
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