- CVS Health (Charleston, WV)
- … 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 (Charleston, WV)
- …+ 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 (Charleston, WV)
- …set by the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... enrolled in Medicare STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected… more
- Cardinal Health (Charleston, WV)
- …payers, pharmacists and manufacturers for integrated care coordination and better patient management . Backed by nearly 100 years of experience, with more than 40,000 ... currently have a career opening for a Reimbursement Solutions Analyst. **What Clinical Operations contributes to Cardinal Health** Clinical Operations is… more