- CVS Health (St. Paul, MN)
- … 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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Cross and Blue Shield of Minnesota Position Title: Principal Provider Performance Clinical Consultant Location: Hybrid | Eagan, Minnesota Career Area: Strategic ... and leading consultative conversations with provider groups about opportunities to improve clinical and cost/ utilization trend. * Responsible for developing and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and leading consultative conversations with provider groups about opportunities to improve clinical and cost/ utilization trend. * Responsible for developing and ... all lines of business. The role works in tandem with the Manager of Clinical Consultation, Pr Provider Performance Clinical Consultants, and the Medical Director… more
- CVS Health (St. Paul, MN)
- …+ 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 (St. Paul, MN)
- …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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …This individual pulls and synthesizes data across multiple domains, including utilization management , prior authorization, claims, denials, and appeals. Their ... focus in the department include but are not limited to provider, health management , quality, product development and client/member analytics. A typical day for the… more