- CVS Health (Harrisburg, PA)
- …of time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all ... aspects of the utilization /benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and… 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 ... zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required +...+ Managed Care experience + Discharge planning experience + Utilization Management experience **Education** Associates Degree or… more
- CVS Health (Harrisburg, PA)
- …to customer data analysis. Working proactively with the account team, Care management teams, peers, and other key enterprise partners to support our commercial ... plan sponsors. The Clinical Program Consultant fulfills the company mission of helping people on...consultative clinical insights based on analysis of clinical plan utilization and impact of member behavior on medical plan… more
- UPMC (Pittsburgh, PA)
- …documentation within the medical record to ensure that all patient resource utilization , principal diagnosis, secondary diagnoses, and PCS procedures have been coded ... to coding and compliance guidelines. + Meet with coding management as scheduled to review progress, discuss problems, and...System and DRG selection; OR specific knowledge as a consultant in Medical Record coding and DRG assignment required.… more
- Wellpath (Chester, PA)
- …the organization's Code of Conduct. + Demonstrates knowledge of risk management , clinical precautions, infection control, fall prevention, utilization of ... improvement activities,providesdirect supervision, and serves as a resource and consultant to nursing staff. + Monitorssafety issues,evaluateservicedeliveryand staff growth,… more