- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Medical Director 's primary responsibility is the review of medical authorizations to determine the medical ... of a given service, level of care, or medical item/supply. The Medical Director 's work assignments involve moderately complex to complex issues where the analysis of… more
- Evolent Health (Harrisburg, PA)
- …a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to ... medical, pharmacy and ancillary claims data, membership data, clinical operational data ( UM & CM), or other healthcare data- **Required.** + Familiarity with Power… more
- CVS Health (Harrisburg, PA)
- …health care more personal, convenient and affordable. Position Summary The Dental Director - Commercial and Medicare Advantage is an individual contributor who will ... accountable to the governing body and Quality Management Committee for all QM and UM activities and initiatives + Is familiar with local standards of dental practice… more
- Highmark Health (Harrisburg, PA)
- …in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, ... overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures to… more