- Highmark Health (Madison, WI)
- …Description :** **JOB SUMMARY** This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses ... member, and then creates the case (data entry) in Highmark's Utilization Management system for Prior Authorization clinical review. Ensures all accurate… more
- Molina Healthcare (Madison, WI)
- …example, such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding. * ... Healthcare and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake ,… more