- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects… more
- CVS Health (Harrisburg, PA)
- …Must be willing and able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work schedules will include weekend/holiday ... Qualifications** + Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or Nursing Diploma… more
- CVS Health (Harrisburg, PA)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Eastern zones -BSN… more
- CVS Health (Harrisburg, PA)
- …3+ years of Nursing experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical ... and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in… more
- CVS Health (Harrisburg, PA)
- …and other key enterprise partners to support our commercial plan sponsors. The Clinical Program Consultant fulfills the company mission of helping people on ... consultant is empowered to: + Provide progressive consultative clinical insights based on analysis of clinical ...consultative clinical insights based on analysis of clinical plan utilization and impact of member… more
- UPMC (Pittsburgh, PA)
- …with hospital administration and clinical teams. + Experience in utilization management and care coordination. + In-depth understanding of regulatory ... The Regional Medical Director, CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This… more
- Prime Therapeutics (Harrisburg, PA)
- …passion and drives every decision we make. **Job Posting Title** Pharmacy Network Management Consultant - Remote **Job Description** The Network Management ... Consultant is responsible for development, performance and management of Prime's retail, mail, specialty, and quality-based networks aligning with Prime's Supply… more
- Penn Medicine (Philadelphia, PA)
- …Research with a focus on supply chain, patient throughput, resource allocation and utilization , queuing theory and capacity management to help optimize business ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- Cardinal Health (Harrisburg, PA)
- **_What Specialty Networks contributes to Cardinal Health_** Specialty Networks creates clinical & economic value for independent specialty providers & partners in ... Networks in creating value to the members in their clinical , operational, and economical goals. This individual will be...Member Profiles and overall success of membership network with utilization and optimization of Salesforce keeping up to date… more