- Magellan Health Services (Boise, ID)
- …supervision. Project management skills and demonstrated experience. General Job Information Title Quality Clinical Reviewer Grade 25 Work Experience - ... and external reporting. Interacts with multiple stakeholders internally and externally. Provides clinical reviews of Quality of Care (QOC) and Critical/Adverse… more
- Merck (Boise, ID)
- …and new indications for existing products. We ensure we conduct high quality clinical trials by integrating state-of-the-art technology and applying rigorous ... clinical trials conducted worldwide. In partnership with the Clinical Quality Operations Lead (CQOL) and Head...+ Collectively and periodically (eg quarterly) perform a TA-level review of quality plans and risk mitigation… more
- Wolters Kluwer (Boise, ID)
- …care to provide advanced clinical decision support solutions that measurably improve clinical effectiveness. The Senior Clinical Quality Analyst will use ... of pharmacotherapy and disease/condition and patient-specific variables. + Perform ongoing clinical data analysis and quality control activities related to… more
- J&J Family of Companies (Boise, ID)
- …development, lifecycle management, supplier management, while providing overall preclinical and clinical quality oversight. This leader is responsible for ... the base RDQ operating model. + Owns CAPA/ Data Review Activities as applicable related to remediation / integration...**Relocation Eligible:** No **Travel** Yes, 25 % of the Time **Job Function** Clinical Quality **Req ID:**… more
- Trinity Health (Boise, ID)
- …delivery of services for a select group of patients. To help achieve quality clinical and cost outcomes, incorporates real-time contacts with physicians, ... virtues, we pride ourselves on exceptional service and the highest quality of care. **GENERAL SUMMARY AND PURPOSE:** Provides hospital case management/utilization… more
- Evolent Health (Boise, ID)
- …Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Provides clinical rationale for standard ... the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer , Interventional Pain Management, you will...within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- Prime Therapeutics (Boise, ID)
- … clinical research and analytics that improve medical cost savings and provide clinical quality initiatives + Manages current clients in all Medical Pharmacy ... drives every decision we make. **Job Posting Title** Director, Specialty Clinical Solutions- RPH/PharmD required- REMOTE **Job Description Summary** Responsible for… more
- Prime Therapeutics (Boise, ID)
- …fuels our passion and drives every decision we make. **Job Posting Title** Physician Clinical Reviewer , MRx - Oncology - REMOTE **Job Description Summary** Key ... 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 (Boise, ID)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer , you will be a key member of the utilization management team. ... provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD… more
- Prime Therapeutics (Boise, ID)
- …accurately and on time. **Responsibilities** + 7+ years of experience in clinical operations, quality , network, pharmacy or project management. + Project ... our passion and drives every decision we make. **Job Posting Title** Manager, Clinical Pharmacy Programs- REMOTE **Job Description Summary** Plays a key role in… more
- Elevance Health (Meridian, ID)
- …in a state or territory of the United States when conducting a peer clinical review . + For URAC accredited areas, the following professional competencies apply: ... Friday from 9:30 am - 6:00 pm **PST** The ** Reviewer -Therapy Services** is responsible for the review...requirements. + Researches and obtains additional data, consults with clinical reviewers and medical directors, when necessary. + Acts… more
- Prime Therapeutics (Boise, ID)
- …including clinical projects as determined by business needs. Collaborating with Clinical Operations, IT, Quality , and Compliance as needed for program ... and drives every decision we make. **Job Posting Title** Clinical Pharmacist/Algorithm- REMOTE **Job Description Summary** Performs prospective and/or retrospective… more
- Intermountain Health (Boise, ID)
- …healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class ... interpersonal communication skills Subject matter expertise in healthcare or related data ( Clinical Programs, Clinical Services, Compliance, Quality , Revenue… more
- CenterWell (Boise, ID)
- … innovation and care model development. + Understanding and comfort with population clinical , quality , and financial drivers in full risk care delivery, ideally ... and help us put health first** The AVP, Complex Care will lead clinical strategy and opportunity assessment around new value-based opportunities and programs that… more
- Prime Therapeutics (Boise, ID)
- …direct, control and monitor project activities. + 5+ years' experience in clinical operations, quality , network, pharmacy or project management. + Project ... Manager - Remote in Raleigh, NC **Job Description Summary** Leads the clinical support for various multi-functional projects critical to the company in achieving… more
- Magellan Health Services (ID)
- …that address performance gaps. + Analyzes performance and develop, in consultation with clinical and quality management, improvements in clinical processes. ... staff on policies, standards, computer systems, service delivery expectations, quality monitoring and regulation and accreditation specifics. Collaborates with COE… more
- Prime Therapeutics (Boise, ID)
- …and Therapeutics (P&T) Committee. **Responsibilities** + 3-5 years' experience in clinical operations, quality , network, pharmacy or project management OR ... in various multi-functional projects critical to the company in achieving its clinical and operational goals and objectives. Develops, implements and monitors … more
- Intermountain Health (Burley, ID)
- …healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class ... and legal requirements. Evaluate: + Evaluates patient response to interventions through review of achievement of goals, clinical outcomes, and patient and… more
- Kaniksu Community Health (Sandpoint, ID)
- …diabetes by 20%. + We rank in the top 10% of CHC's in the country for clinical quality . + We report the highest level of control in the state for our ... dental, and behavioral health. From pediatric to geriatrics, we believe that quality healthcare should be accessible, approachable and affordable for everyone. We… more
- Intermountain Health (Burley, ID)
- …healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class ... professional growth and development through participation in education programs and review of current literature and develop, lead, and/or participate in appropriate… more