- CVS Health (Harrisburg, PA)
- …in medical management, including Utilization Management (UM) and Case Management ( CM ). + Strong understanding of healthcare quality, accreditation processes, and ... NCQA standards. + Licensed clinical professional ( RN preferred). + Excellent analytical, organizational, and communication skills. + Proficiency in audit… more
- Highmark Health (Harrisburg, PA)
- …experience + 1 year in a clinical setting **Preferred** + 5 years in UM/ CM /QA/Managed Care + 1 year in advanced training and experience in cognitive behavioral ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...or WV or DE or NY is required. Other RN license(s), if applicable, must be obtained within the… more
- CSL Behring (King Of Prussia, PA)
- …process optimization. This role ensures the efficiency of GSPV processes, not only within CM but across all PV and key interface functions. The aim is to optimize ... in the context of case processing. **Qualifications and Experience Requirements:** + BS/BA, RN , Pharmacist, or similar. + Minimum of 10 years of Clinical Trial and… more