- CenterWell (Lancaster, PA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... at our Lancaster, PA branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care ...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Highmark Health (Pittsburgh, PA)
- …party payers. + Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract ... etc. Serves as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer guidelines. Adheres to… more
- Highmark Health (Erie, PA)
- …and interdisciplinary team partners including but not limited to: appropriateness of care , documentation requirements, utilization review principles and ... serving the people in the Lake Erie region since 1875 with a quality of care and service second to none! **Allegheny Health Network** At AHN, employees trust working… more
- Amergis (Pittsburgh, PA)
- …and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making ... Week The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources,… more
- Devereux Advanced Behavioral Health (Malvern, PA)
- …could be longer based on the presenting symptoms. Every day as an Admissions & Utilization Review Manager you will + Supervise overall operations of DCBHC ... career to the next level. **Being an Admissions & Utilization Review (UR) Manager Devereux...Chester County, Pennsylvania, - employs a team of acute care professionals dedicated to meeting the needs of children… more
- St. Luke's University Health Network (Allentown, PA)
- …agencies, physicians, nursing staff, department managers, ancillary departments, and the Manager regarding variances, aspects of patient care management. + ... the age of the patient treated. + Performs admission review on all inpatients. Attends daily patient rounds and...transfers for admission and/or referral to appropriate level of care . + May assist in the utilization … more
- CVS Health (Harrisburg, PA)
- …transferring patients to lower levels of care . + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + 1+ ... Responsibilities** + This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured… more
- Burns & McDonnell (Conshohocken, PA)
- **Description** The Construction Project Manager supports the Engineer Procure Construct (EPC) Project Manager or Program Manager to oversee day-to-day ... through project completion and warranty periods. The Construction Project Manager is responsible for managing the construction project safety, quality,… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …+ Experience in a combination of home care management, case management review , utilization review , social service support, insurance reimbursement and ... and documenting coverage options for retail and specialty medications. The Case Manager 's primary duty is to assist customers with chronic illnesses in their… more
- Fresenius Medical Center (Pottstown, PA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care , you will ensure that quality patient care is delivered while maintaining clinical ... of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing...leading your business, and advanced leadership. As a Clinical Manager , you may advance your career into an Area… more
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