• Utilization Management

    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 (11/19/25)
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  • Sr Coordinator, Complaint and Appeals Operations

    CVS Health (Dover, DE)
    …relations; customer service or audit experience. Experience in research and analysis of utilization management systems. *Fluent in Spanish, both oral and written ... accuracy and appropriateness of a benefit/administrative denial. Can review a clinical determination and understand rationale for decision. Able to research claim… more
    CVS Health (11/20/25)
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