Role Description Provide best-in-class personalized patient services to ensure a positive patient experience in support of Sanofi General Medicines business priorities. Driven by the complexity of patient identification, treatment administration intricacies, and access gateways, this role must support both internal and external care teams in the overall patient journey. The Clinical Educator (CE) is a key field-based member of the Tzield Patient Services team and subject matter expert for Tzield and T1D. In this high touch role, the CE will assist patients and caregivers with accessing Sanofi’s FDA-approved 14-day T1D infusion therapy. The CE provides disease and product information and ongoing support, when appropriate, to T1D Patients and their caregivers. The CE establishes and maintains a strong working relationship with: - Endocrinology Health Care providers (MD, NP, PA) - HCFs (Nurses, Pharm D, Leadership) - HHA nurses who provide in-home care for our patients The CE provides sophisticated and in-depth education on the product and related access hurdles to ensure a seamless experience for patients. He/she is a subject matter expert and critical thinker on disease state, product, administration, and services. The CE works collaboratively with cross-functional team members to facilitate timely and ongoing access to therapy and has a high level of emotional intelligence to navigate both internal and external partners and customers. They are solely responsible for ensuring that all patients are given an opportunity to participate in our Patient Mentor program and facilitate the set-up and delivery of the interaction. CE's must also ensure full compliance with all corporate and industry policies and legal and regulatory requirements, for all field activities and report all AEs. This is a regionally aligned field-based role. Join the team transforming care for people with immune challenges, rare diseases, cancers, and neurological conditions. In Specialty Care, you’ll help deliver breakthrough treatments that bring hope to patients with some of the highest unmet needs. Main Responsibilities - Leads education and awareness efforts of disease state, inheritance, diagnostic and product information to patients and families through telephone communication, live/virtual patient and family meetings, and patient education programs. - Facilitates a Patient Mentor program by setting up and moderating a 1:1 interaction for new patients. - Assesses all enrolled patients’ needs and develops action plans that facilitate the treatment process as recommended by the patient’s healthcare provider. - Works with cross-functional partners to identify patient-specific barriers and develop action plans for resolution. - Demonstrates accountability for action plan execution and drives for success and results. - Supports the complex pull-through process of Tzield patients by maintaining excellent communication with the Matrix team, HCPs, and the Patient. - Provides ongoing education to the HCPs regarding the infusion process based on the approved PI. - Delivers in-depth disease and product in-services for home health care providers of patients receiving Sanofi treatment within the home to ensure optimal care and adherence to prescribed dosing. - Maintains expertise through continuing medical and scientific education including attendance at relevant symposiums, scientific workshops, preceptorships, and review of key journals, and successful completion of internal training programs. - Increases disease awareness by completing community and healthcare advocate educational outreach programs. - Meets documentation requirements in CRM system to facilitate tracking of critical metrics. - Delivers on key objectives established annually. - Participates/travels to Patient support programs as needed. - Must be able to travel extensively (60 to 80%). - Ensures full compliance with all corporate and industry policies and legal and regulatory requirements for all regional commercial activities. Qualifications - Bachelor’s or Master’s Degree in Health Care/ Life Sciences/ Nursing or related subjects. - 3+ years of experience in biotechnology, pharmaceutical, or healthcare industry. Requirements - 3+ years previous experience in a field-based commercial or medical role in a pharmaceutical or biotech company desired. - Prior product launch experience. - Ability to present to small and large groups of patients, caregivers, and Health Care professionals. - Ability to travel up to 80% within a territory is required; ability to travel to meetings/trainings/programs as necessary - additional travel will be required within the assigned geography. - Valid Driver’s License. - Previous commercial and/or clinical experience with IV infusions is preferred. - Previous T1 Diabetes experience strongly preferred, CDE certification. Benefits - Bring the miracles of science to life alongside a supportive, future-focused team. - Discover endless opportunities to grow your talent and drive your career, whether it’s through a promotion or lateral move, at home or internationally. - Enjoy a thoughtful, well-crafted rewards package that recognizes your contribution and amplifies your impact. - Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs, and at least 14 weeks’ gender-neutral parental leave.

Role Description The Clinical Pharmacist is responsible for promoting appropriate and/or efficient utilization review of prescription drug claims among BCBSM participating physicians. This position is also responsible for the education of physicians and influencing of prescribing patterns to reduce BCBSM’s drug benefit payout and improve the quality of the benefits as it relates to our members. The incumbent serves as the liaison to the Medical Policy department assisting with the development of medical policy as it applies to drugs. - Provides clinical coverage review for medication requests. - Develops, implements, and updates Drug Utilization Review/Due Programs. - Provides effective and efficient communication of pharmacotherapy issues. - Develops and implements a variety of behavior modification principles to influence physicians to prescribe appropriately. - Identifies target physicians, establishes credibility and utilizes both verbal and written communications to modify behavior. - Serves as the key clinical support person for researching prescription drug inquiries. - Develops, implements and monitors the Corporate Drug Information Center. - Develops, implements and continually updates physician and patient educational materials. - Supports Drug Formulary development and serves on the BCBSM P and T Committee. - Serves as liaison to medical Policy assisting with the development of medical policy as it applies to drugs. - Participates in clinical and operational process improvement and cost savings opportunities. - Supports review and resolution of clinical and compliance grievances and appeals. - Supports clinical initiatives related to NCQA, HEDIS, CAHPS and STAR measures. - Adheres to Pharmacy Policies and Procedures. Qualifications - Must have superior oral and written communication skills and expertise in the design of presentations. - The incumbent must have the ability to obtain and devise relevant data and information from existing MIS Systems. - An understanding or knowledge of drug claims processing systems and/or medical information systems is preferred. - Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. - Ability to write reports, business correspondence, and procedure manuals. - Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Requirements - Relevant combination of education and experience may be considered in lieu of degree. - Bachelor’s degree or Doctorate in Pharmacy. - Current unrestricted Pharmacy License required, MI Pharmacy License preferred. - Three years of experience consulting with physicians on pharmaceutical issues or completion of an accredited American Society of Health-System Pharmacists/Academy of Managed Care Pharmacy, AMCP/ASHP, Managed Care Pharmacy or Pharmacy Practice Residency. - Drug Information Specialist with proven background and skills may also be considered. Benefits - Pay Range: Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. - It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $107,000 and $179,300. - EEO Statement: All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability. - Candidates are hired on an "at will" basis. Nothing herein is intended to create a contract.

Clinical Denials and Appeals RN US - Remote (Any location) Full time job requisition id 40382 Job Family: Clinical Appeals Nurse Travel Required: None Clearance Required: None What You Will Do: - Conduct pre‑ and post‑service medical necessity reviews for inpatient, observation, and outpatient hospital encounters using evidence‑based criteria such as InterQual and Milliman Care Guidelines. - Perform retrospective medical record reviews to validate completeness and accuracy of physician and clinical documentation supporting level of care and services rendered. - Identify denial root causes and determine appeal viability based on payer policies, regulatory guidance, and clinical standards. - Prepare, submit, and track clinical appeals, including written appeals. - Collaborate with Patient Access, Case Management, Utilization Management, Coding, and Mid‑Revenue Cycle teams to resolve denials and prevent recurrence. - Research and apply payer‑specific policies, CMS regulations, and contractual language to support appeal arguments. - Track and report denial and appeal outcomes, identify trends, and provide recommendations for process improvement and staff education. - Maintain accurate documentation of all review activities in hospital and payer systems in accordance with compliance standards. What You Will Need: - Current unrestricted Registered Nurse license in the state you reside - Bachelor's degree and 4-6 years of prior relevant experience in acute care clinical experience in hospital setting or Associates Degree and 6-8 years of prior relevant experience in acute care clinical experience in hospital setting (Relevant experience may be substituted for formal education or advanced degree). - Experience in clinical denials, utilization review, case management, or appeals required What Would Be Nice To Have: - Bachelor of Science in Nursing - Master’s degree in Nursing - Experience with InterQual and/or Milliman Care Guidelines, and electronic medical record systems. - Compact State RN License - Experience with inpatient level‑of‑care denials, DRG downgrades, and CMS payer rules. - Strong knowledge of hospital revenue cycle workflows, medical necessity review, and payer regulations. - Excellent analytical, organizational, and written communication skills with the ability to independently manage multiple cases. The annual salary range for this position is $68,000.00-$113,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. Benefits include: - Medical, Rx, Dental & Vision Insurance - Personal and Family Sick Time & Company Paid Holidays - Position may be eligible for a discretionary variable incentive bonus - Parental Leave - 401(k) Retirement Plan - Basic Life & Supplemental Life - Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts - Short-Term & Long-Term Disability - Tuition Reimbursement, Personal Development & Learning Opportunities - Skills Development & Certifications - Employee Referral Program - Corporate Sponsored Events & Community Outreach - Emergency Back-Up Childcare Program About Guidehouse Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Title: Clinical Specialist (RN - Vascular Access) - Atlanta Location: Franklin Lakes, NJ, Atlanta, GA, United States Job ID R-548752 Category Sales Location Atlanta, Georgia Job Description: We are the people who give possibilities purpose BD is one of the largest global medical technology companies in the world. Advancing the world of health is our Purpose, and it's no small feat. It takes the imagination and passion of all of us-from design and engineering to the manufacturing and marketing of our billions of MedTech products per year-to look at the impossible and find transformative solutions that turn dreams into possibilities. Job Description About the role: As a Clinical Specialist, you will play a crucial role in providing flawless clinical support and education to our valued customers. Join us and be part of a proven organization that strives for excellence in everything we do. The Clinical Specialist is a resource for the execution of the Medication Delivery Solutions value-added clinical business strategy. The role implements clinical programs and initiatives that differentiate the MDS product portfolio based on improved clinical outcomes and process enhancements which may result in a lower cost-in-use. The expertise and credentials of the Clinical Specialist enhances the credibility of recommendations to customers and strengthens customer service and support. This support to customers is achieved through recommending best practice and facilitating education. The Clinical Specialist actively engages in conversion management, product implementation and training of Medication Delivery Solutions products. The Clinical Specialist reports directly to the Clinical Manager. Works primarily in a geographically defined territory; however, based on clinical needs, could assist outside of the region. Key Responsibilities: - Manage responsibilities within the allotted Travel & Expense budget. - Provide monthly updates to the Clinical Manager on regional training activities and support provided in the region. - Facilitate customer training classes to support conversion or retention opportunities for key customers. - Collaborate with the Regional Team to clinically support customer engagements from pre-sale through post-conversion. - Develop strong working relationships with end-users while providing product in-servicing and clinical education. - Provide routine follow-up support to customers at end-user locations as needed. - Conduct regional training for contractual nursing support as needed. - Collaborate with the Clinical Manager and Regional Business Manager to optimize scheduling and activities for maximum results. - Conduct Vascular Access Management assessments programs to support both Vascular Care and Vascular Access sales organizations. Education & Credentials: - Associate of Science degree in Nursing required; bachelor's degree in nursing or science-based field preferred. - Active Registered Nurse (RN) license in good standing - Advanced certification in vascular access and/or critical care nursing preferred (such as CRNI, VA-BC, CCRN, CEN, or equivalent) Experience: - Minimum 3 years of clinical experience specializing in ultrasound-guided procedures and vascular access devices preferred (including PICC lines, midlines, and related technologies). - Demonstrated proficiency in patient assessment, device selection, and insertion techniques. - Possesses a strong understanding and knowledge of infusion therapy, vascular access, and key disease states served by MDS products. Additional Skills: - Excellent communication and training abilities for clinical education and customer support. - Ability to work independently and collaboratively with multidisciplinary teams. - Competence in troubleshooting and providing clinical expertise for BD vascular access products. - Proven training skills to conduct educational courses. - Persuasive and credible; able to influence without authority. - Ability to travel up to 70% of the time. - Must possess and maintain a valid state-issued driver's license and meet BD's auto safety standards At BD, we prioritize on-site collaboration because we believe it fosters creativity, innovation, and effective problem-solving, which are essential in the fast-paced healthcare industry. For most roles, we require a minimum of 4 days of in-office presence per week to maintain our culture of excellence and ensure smooth operations, while also recognizing the importance of flexibility and work-life balance. Remote or field-based positions will have different workplace arrangements which will be indicated in the job posting. For certain roles at BD, employment is contingent upon the Company's receipt of sufficient proof that you are fully vaccinated against COVID-19. In some locations, testing for COVID-19 may be available and/or required. Consistent with BD's Workplace Accommodations Policy, requests for accommodation will be considered pursuant to applicable law. At BD, we are committed to supporting our associates' well-being, development, and success through a performance-based culture. For this position, BD offers a competitive compensation package along with the following benefits specific to this role: - Annual Bonus - Potential Discretionary LTI Bonus - Potential reimbursement of vehicle use/mileage - Potential reimbursement of phone use Health and Well-being Benefits - Medical coverage - Health Savings Accounts - Flexible Spending Accounts - Dental coverage - Vision coverage - Hospital Care Insurance - Critical Illness Insurance - Accidental Injury Insurance - Life and AD&D insurance - Short-term disability coverage - Long-term disability insurance - Long-term care with life insurance Other Well-being Resources - Anxiety management program - Wellness incentives - Sleep improvement program - Diabetes management program - Virtual physical therapy - Emotional/mental health support programs - Weight management programs - Gastrointestinal health program - Substance use management program - Musculoskeletal surgery, cancer treatment, and bariatric surgery benefit Retirement and Financial Well-being - BD 401(k) Plan - BD Deferred Compensation and Restoration Plan - 529 College Savings Plan - Financial counseling - Baxter Credit Union (BCU) - Daily Pay - College financial aid and application guidance Life Balance Programs - Paid time off (PTO), including all required State leaves - Educational assistance/tuition reimbursement - MetLife Legal Plan - Group auto and home insurance - Pet insurance - Commuter benefits - Discounts on products and services - Academic Achievement Scholarship - Service Recognition Awards - Employer matching donation - Workplace accommodations Other Life Balance Programs - Adoption assistance - Backup day care and eldercare - Support for neurodivergent adults, children, and caregivers - Caregiving assistance for elderly and special needs individuals - Employee Assistance Program (EAP) - Paid Parental Leave - Support for fertility, birthing, postpartum, and age-related hormonal changes Leave Programs - Bereavement leaves - Military leave - Personal leave - Family and Medical Leave (FML) - Jury and Witness Duty Leave Salary ranges have been implemented to reward associates fairly and competitively, as well as to support recognition of associates' progress, ranging from entry level to experts in their field, and talent mobility. There are many factors, such as location, that contribute to the range displayed. The salary offered to a successful candidate is based on experience, education, skills, and actual work location. Salary ranges may vary for Field-based and Remote roles. $85,537 - $141,135 (Range includes Annual Base + Incentives) Why Join Us? To find purpose in the possibilities, we need people who can see the bigger picture, who understand the human story that underpins everything we do. We welcome people with the imagination and drive to help us reinvent the future of healthcare. At BD, you'll discover a culture in which you can learn, grow and thrive. We believe that when people connect in person, we learn faster, collaborate more deeply, and build a stronger culture. Join us and enjoy a culture where face-to-face collaboration supports your learning, your progress, and your success. To learn more about BD visit https://bd.com/careers. Becton, Dickinson, and Company is an Equal Opportunity Employer. We evaluate applicants without regard to race, color, religion, age, sex, creed, national origin, ancestry, citizenship status, marital or domestic or civil union status, familial status, affectional or sexual orientation, gender identity or expression, genetics, disability, military eligibility or veteran status, and other legally protected characteristics. Required Skills Optional Skills Primary Work Location USA NJ - Franklin Lakes Additional Locations Work Shift NA (United States of America)