115,053 Enterprise Business Development Representative Jobs Nationwide

* Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical...

* Provide daily utilization oversight and external communication with network physicians and hospitals * Daily UM reviews - authorizations...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...

* Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided...

* Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Work to improve quality and promote evidence-based medicine * Provide information on quality and efficiency to doctors, patients and customers...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...

* Provide daily utilization oversight and external communication with network physicians and hospitals * Daily UM reviews - authorizations...

* Provide daily utilization oversight and external communication with network physicians and hospitals * Daily UM reviews - authorizations...

* Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD...

* Provide daily utilization oversight and external communication with network physicians and hospitals * Daily UM reviews - authorizations...

* Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage...

* Support case and disease management teams to achieve optimal clinical outcomes for high risk populations * Proficient in evidence based clinical...

* Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided...

* Provide daily utilization oversight and external communication with network physicians and hospitals * Daily UM reviews - authorizations...

* Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided...

* Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence - based guidelines...