- Jazz Pharmaceuticals (Philadelphia, PA)
- …analyses, and other advanced analyses as required for brand performance assessment/ management Evaluate product utilization data (internal and external) at ... of strong analytical, problem solving, strategic thinking, planning, and project management skills. Contribute to strategic insights sharing across the franchise.… more
- Merck & Co. (North Wales, PA)
- …databases to discover disease prevalence and risk factors, describe drug utilization patterns and disease progression, answer clinical development questions, and ... experience as a programming mentorFamiliarity with statistics, clinical and data management concepts as applied to drug/vaccine development within the pharmaceutical… more
- Lovesac (King Of Prussia, PA)
- …unique experience for them. You will identify the customer's needs through utilization of the Lovesac proprietary selling process through demonstrating, quoting and ... showroom you will share that passion for the brand and product through utilization of social media outlets, hosting live demonstrations, engaging in live chats and… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... setting **Preferred** + Experience in UM/CM/QA/Managed Care + Medical/Surgical experience + Utilization Management (UM) or (UR) Utilization Review experience… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Penn Medicine (Lancaster, PA)
- …Medicine Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for ... under pressure, we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible for evaluating medical records to… more
- Cognizant (Harrisburg, PA)
- …+ Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' ... in health care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial… more
- Highmark Health (Harrisburg, PA)
- …coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims… more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **About this role** The Medical Director of Utilization Management leads and oversees utilization review, case ... appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders,… more
- CVS Health (Harrisburg, PA)
- …all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit ... solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other… more
