- CVS Health (Harrisburg, PA)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization . + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + UMNC meets set productivity and quality expectations. +… more
- CVS Health (Harrisburg, PA)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
- CenterWell (Harrisburg, PA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
- WellSpan Health (York, PA)
- …**_Occasional Weekend_** **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use ... patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** **Essential… more
- WellSpan Health (Lebanon, PA)
- …Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of ... address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** + Reviews… more
- Penn Medicine (Philadelphia, PA)
- …the organization's goals and objectives for assuring the effective and efficient utilization of health care services. The Physician Advisor is a physician serving ... hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership. The Physician Advisor shall… more
- Wolters Kluwer (Philadelphia, PA)
- …Engagement Manager plays a high-impact role in managing strategy and product utilization across the Wolters Kluwer Health's Clinical Decision Support & Provider ... are established and strengthened, drive product adoption and ensure utilization goals are achieved to maximize value realization, implementation projects… more
- Highmark Health (Harrisburg, PA)
- …This role supports the full application product lifecycle for **clinical and utilization management software** , with a specific focus on driving key technical ... They function as a pivotal bridge, translating high-level **clinical and utilization management software** business needs into detailed technical requirements for… more
- Centene Corporation (Harrisburg, PA)
- …in Family Medicine or Internal Medicine or Emergency Medicine + Utilization Management experience and knowledge of quality accreditation standards highly preferred ... for the business unit. + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs… more
- UPMC (Pittsburgh, PA)
- Are you a registered nurse with a background in utilization management? UPMC Health Plan is looking for you! We are hiring a full-time Utilization Management ... will be given to candidates located in Pennsylvania. The Utilization Management (UM) Care Manager is responsible for ...Utilization Management (UM) Care Manager is responsible for utilization review of health plan services and assessment of… more