- CVS Health (PA)
- …No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in a ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
- CVS Health (PA)
- …PM EST** We are seeking a compassionate, clinically skilled professional to join our Utilization Management team. In this role, you will use your behavioral ... as a clinical resource to internal teams and external partners regarding utilization management processes. + Perform responsibilities while working primarily at… 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