Posted 10 days ago
The Utilization Management Nurse Consultant reviews clinical cases, makes coverage determinations using evidence-based guidelines, and coordinates transitions to home care for Florida Medicare members. The role applies nursing judgment to utilization and benefit management, supports care quality and outcomes, and serves as a clinical resource for stakeholders.
Posted a month ago
The Clinical Advisor will use oncology and rare-disease pharmacy expertise to shape clinical strategy and develop payor-focused specialty products and programs. Responsibilities include building product roadmaps, defining clinical content and workflows, advising internal and external stakeholders, and leading clinical governance to improve care quality, patient and provider experience, and cost management.
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