- CVS Health (Harrisburg, PA)
- …a hospital setting required for either BH or RN -1+ years of utilization review/ utilization management required (ie concurrent review, pre-certifications) ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- Centene Corporation (Harrisburg, PA)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... TIME ZONE/CENTRAL TIME ZONE.** **IDEAL APPLICANTS WILL HAVE CHILDREN/ADOLECENT BEHAVIORAL HEALTH EXPERIENCE AND HOLD A PENNSYLVANIA LICENSURE.** **Position… more
- Highmark Health (Harrisburg, PA)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- WellSpan Health (Lewisburg, PA)
- …family. + Carries out the written plan of care as established by the primary clinician . The primary clinician will provide supervisory visits in the home every ... changes in the patient's condition or family situation to the primary clinician or, in their absence, to the appropriate manager/coordinator. + Maintains established… more