- CVS Health (Harrisburg, PA)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- CVS Health (Harrisburg, PA)
- … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. ... listening, and use of a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed,… more
- CVS Health (Harrisburg, PA)
- …+ 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 (Harrisburg, PA)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …and quality of care. Functions as a competent consultant in clinical practice and revenue utilization review. *Systematically evaluating current practice, ... Summary The Revenue Utilization Review (RUR) Assistant Nurse Manager (ANM) is...reviewers representing third-party payers (TPPs). The RUR ANM possesses clinical and nurse leadership skills and demonstrates this through… more
- UPMC (Harrisburg, PA)
- …years of clinical experience + Minimum of 2 years of relevant clinical specialty experience + Leadership and project management experience preferred + ... infants, offering advanced respiratory support, surgical recovery, and complex medical management . The unit is staffed by a dedicated team of neonatologists,… more
- Highmark Health (Camp Hill, PA)
- …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