- CVS Health (Dover, DE)
- … clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Dover, DE)
- …+ Human Resource and/or Supervisory experience. + Case management , Utilization Review, or Utilization Management background preferred. **Education** ... Friday, 11:00 am to 8:00 pm Eastern Time.** The Consultant provides management consultation to corporate clients...clinical assessments and triage into care. Performs case management across scope of all types of management… more
- Highmark Health (Dover, DE)
- …needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, ... while also being capable of developing technical solutions. The consultant will act as a senior resource within the...the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The… more
- Highmark Health (Wilmington, DE)
- …for innovation and ensure compliance with evolving regulations. By leveraging clinical expertise and strategic thinking, the consultant drives data-informed ... in partnership with our external entity partners + Provide Clinical Expertise and stakeholder engagement for all VBR contracts...Quality Improvement + 3 - 5 years in Care Management + 3 - 5 years in Utilization… more