- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist , will analyze clinical information, contracts,… more
- CVS Health (Annapolis, MD)
- …as what we deliver. **Position Summary** The Analyst, Medical Cost Analytics / Utilization Management role will analytics to evaluate scenarios and make ... and support decision making. The Analyst will be regarded as a specialist , analyzing large data sets in real-time databases and developing mathematical approaches… more
- Anywhere Real Estate (Baltimore, MD)
- The **Commercial** **Sales Specialist ** participates in and supports sales management efforts, by assisting the **Commercial Director** in a range of agent ... and detail-oriented + Must be proficient with technology tools and teaching agents on utilization of tools + Must have a valid Real Estate or Broker's license This… more
- Highmark Health (Annapolis, MD)
- … - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care ... Experience in a clinical setting **Preferred** + Certification in utilization management or a related field +...Licensed Marriage and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse. **Preferred** + None **SKILLS** +… more
- CareFirst (Baltimore, MD)
- …plan as needed. Conducts a thorough review of clients' opportunities, utilization patterns, and outcomes to inform provider and health system decision ... and efficiency of patient care and provider communication between patient, PCP, specialist and hospital. Recruits providers and negotiates terms of value based… more
- NTT America Solutions, Inc. (Annapolis, MD)
- …their area of responsibility and /or stakeholder group. These individuals have specialist knowledge and answer queries related to their area of responsibility and/or ... in the assigned stakeholder group through communication, information sharing, and knowledge management . + Actively contribute to the growth and success of the… more
- Verint Systems, Inc. (Annapolis, MD)
- …enrollment processes, including obtaining and analyzing benchmark data and utilization data, identifying trends, preparing recommendations with impact assessments ... covering the four pillars. + Responsible for all aspects of leave management , 401(k), tuition reimbursement, paid time off, annual holiday schedules and worker's… more