- Humana (Harrisburg, PA)
- …and help us put health first** Humana Healthy Horizons in Virginia is seeking a Manager , Utilization Management ( Behavioral Health) who will utilize ... of behavioral health services and/or benefit administration determinations. The Manager , Utilization Management ( Behavioral Health) applies… more
- AmeriHealth Caritas (Harrisburg, PA)
- …applicable, as well as the larger primary care team. The CCM is responsible for proving utilization management and both case and care management , as well as ... ** Behavioral Health Care Manager --PerformCare Pennsylvania** Location:...most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
- CVS Health (Harrisburg, PA)
- …Health Counselor) Preferred Qualifications + Crisis intervention skills preferred managed care/ utilization review experience preferred + Case management and ... thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider… more
- CenterWell (Harrisburg, PA)
- …Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as ... ER visits, readmissions, total cost of care, and reducing acute care utilization ). * Familiarity in integrated care management programs with primary… more
- Centene Corporation (Harrisburg, PA)
- …healthcare environment Required 3+ years of experience in managed care, plus utilization management , care coordination, disease management , Medicare, ... on a regular basis.** **Position Purpose:** Functions as a program development manager in collaboration with Quality, Health Services and Operations business owners… more
- Ford Motor Company (Harrisburg, PA)
- …is best-in-class. **In this position ** The Accessories eCommerce Merchandising Manager is responsible for deeply understanding customer needs and optimizing the ... business value daily by pulling, analyzing, and translating web analytics and behavioral data into actionable insights to enhance sales, conversion, and customer… more
- Ford Motor Company (Harrisburg, PA)
- …is best-in-class. **In this position ** The Non-Vehicle eCommerce Operations Senior Manager is responsible for deeply understanding B2C and B2B Parts and Accessories ... efficiency and customer satisfaction by pulling, analyzing, and translating analytics and behavioral data into actionable insights with forecasted values for each to… more
- Highmark Health (Harrisburg, PA)
- …Description :** **JOB SUMMARY** This job provides Epic application software development management for IT projects. Creates plans and manages activities, within an ... available options, comparing costs and benefits, and recommending solutions. 2 Management Consulting + Identify issues and recommend solutions. + Create presentation… more
- Highmark Health (Harrisburg, PA)
- …actions (promotions, hiring, terminations, etc.) Develops talent, Addresses resource management , cultivates capabilities of staff, planning and coordination of work, ... in first-line resolution of complex technical problems. + Provide Staff Management oversight. + Hire, promote, separate or make recommendations regarding same.… more
- Highmark Health (Harrisburg, PA)
- …actions (promotions, hiring, terminations, etc.) Develops talent, Addresses resource management , cultivates capabilities of staff, planning and coordination of work, ... in first-line resolution of complex technical problems 2. Provides Staff Management oversight * Hires, promotes, separates or makes recommendations regarding same… more
- CenterWell (Harrisburg, PA)
- …health and full-risk frameworks, including patient engagement, clinical professional skillsets, utilization management , care management , clinical information ... the complex needs of seniors and improve health outcomes and avoidable utilization (eg, palliative care, post-acute care, transitions of care) at a population… more
- Highmark Health (Harrisburg, PA)
- …terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and procedures while ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- CenterWell (Harrisburg, PA)
- …optimal patient care, high quality health outcomes, and improved cost and utilization in pharmacy-related care, and serve as a national clinical program leader ... This role reports to the National Director, High Risk Patient Management . Responsibilities will include: + Lead comprehensive clinical pharmacy service development,… more
- Sharecare, Inc. (Harrisburg, PA)
- …other members of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality ... with the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations … more
- Geisinger (Bloomsburg, PA)
- …and facilitate patient needs. + Participates in unit-based decision-making regarding the utilization of evidence based practice. + Provides input to the manager ... spectrum of surgical services, including in-and out- surgery, obstetrics/maternity, behavioral health and a progressive emergency medicine and hospitalist program.… more
- CenterWell (Harrisburg, PA)
- …to ensure enrollment success, identifying member education opportunities to drive maximum utilization of available resources, and directing patients on the use of ... care to seniors, including wellness visits, physical exams, chronic condition management , screenings, minor injury treatment and more. Our unique care model… more