... responsible for the overall clinical support of account and sales specific activities within the Clinical Services division. The incumbent works with leaders in clinical services and sales/account management as a ...

... Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc ...

... . Responsible to efficiently coordinate the clinical review process with contracted external review companies in accordance with all regulatory guidelines. This includes: • the submission and receipt of clinical ...

... Company : Highmark Health Job Description : JOB SUMMARY Direct all p ...

... clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical ...

... clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical ...

... ** 3 - 5 years of post licensure experience in a combination of Behavioral Health Clinical, Case Management and/or Condition Management Experience in a clinical setting **Preferred ...

... accordance with the highest and most current clinical standards. The incumbent reviews escalated cases ... /Management or Public Health EXPERIENCE Required 5 years in Clinical, Direct ...

... management for our community-based palliative care program. In addition, this role will provide clinical ... projects and engagement with process improvement. The role includes recognizing clinical gaps and ...

... clinical and motivational interviewing skills to assess behavioral health, physical health, and social ... conditions to provide comprehensive case management interventions. Conduct telephonic clinical and ...

... then creates the case (data entry) in Highmark's utilization management system for clinical review ...

... , and then creates the case (data entry) in Highmark's utilization management system for clinical review ...

... accordance with the highest and most current clinical standards. The incumbent reviews escalated cases ... /Management or Public Health EXPERIENCE Required 5 years in Clinical, Direct ...

... footprint. Designs, implements and executes strategies and works with cross-functional clinical ... interventions to improve the clinical STARS measures. Lead/participate in both departmental and ...

... Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: ...