- CenterWell (Hartford, CT)
- …Specialty Care to lead strategy and execution for our referral management, payer prior authorization , and specialist network solutions. This role is critical to ... caring community and help us put health first** The Senior Product Owner - Clinical Referral and Specialty Care...track KPIs related to referral throughput, network utilization, and prior authorization efficiency; use data to drive… more
- CenterWell (Hartford, CT)
- …SQL Server administration and query performance tuning + Experience with healthcare and prior authorization data + Experience managing data and pipelines in a ... part of our caring community and help us put health first** The Senior Data and Reporting Professional manages information from various sources, transforming and… more
- CVS Health (Hartford, CT)
- …programs are implemented correctly. Knowledge of utilization management interventions including prior authorization , step therapy, quantity limits, and Oncology ... - Demonstrated in-depth understanding of utilization management and formulary, including prior authorization , step therapy, quantity limits, and Oncology and… more
- The Cigna Group (Bloomfield, CT)
- …higher levels of Management but also understands when higher level of authorization is required. Responsible for compiling and maintaining KPI reports for internal ... Health Services, a division of The Cigna Group, creates pharmacy , care and benefit solutions to improve health and...employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states… more
- Humana (Hartford, CT)
- …Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization , formulary management and clinical programming + ... problems of diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director, internally known as a Clinical Pharmacy Lead, plans,… more