- Deloitte (Harrisburg, PA)
- …PMs, Project Coordinators, etc. + 3+ years of project / program financial management (eg, Planning, Forecasting, Budgeting, Business Case Development, etc.) in ... you will play a key role in leveraging leading program and project management practices and methodologies to enable world-class delivery of our major internal… more
- Penn Medicine (Philadelphia, PA)
- …must be a seasoned med/surg nurse with a minimum of 5 years' experience in Utilization review and 3 years of experience in the Transfer Center.** Summary: + ... hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management … more
- Genesis Healthcare (Mechanicsburg, PA)
- …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... The Director of Rehab is responsible for the efficient management of rehabilitation services in their assigned account(s). This...Director in the timely completion of the annual merit review for therapy staff. 7. Assists Clinical Operations Area… more
- Datavant (Harrisburg, PA)
- …###@datavant.com . We will review your request for reasonable accommodation on a case -by- case basis. For more information about how we collect and use your ... As a Salesforce System Architect, you will be responsible for user management , data maintenance, security configuration, and training users on using Salesforce… more
- UPMC (Pittsburgh, PA)
- …scheduling appointments, and tracking utilization . + Refer members to appropriate case management , health management , or lifestyle programs based on ... the CMA's collaborations, practical comprehension and hands-on experience in clinical care/ utilization management will result by collecting and assisting with… more
- UPMC (Pittsburgh, PA)
- …issues among coding, nursing administration, Patient Business Services, medical staff, case management , and other ancillary departments directly affected by ... to coding and compliance guidelines. + Meet with coding management as scheduled to review progress, discuss...personnel, the medical staff, physician extenders (PAs, CRNPs), nursing case management and ancillary departments. + Assist… more
- Prime Therapeutics (Harrisburg, PA)
- …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + ... for drug services. + Will actively maintain a required case load and the activities to reach overall goals...appeals program. + Participates in meetings and consults with management on regular basis to discuss member interaction and… more
- CVS Health (Harrisburg, PA)
- …will review prior claims to address potential impact on current case management and eligibility status. Focus assessments and/or questionnaires are designed ... impact on our members, who are enrolled in Care Management and present with a wide range of complex...timelines. - Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- Veterans Affairs, Veterans Health Administration (Butler, PA)
- …Possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation ... US State or territory Work Schedule: Monday- Friday; 7:30am- 4:00pm Preferred Experience: Case Management Experience, 5 years + RN Experience desired. Telework:… more
- Penn Medicine (Philadelphia, PA)
- …one week in advance whenever possible. Provide accurate information to billing and case management to assure payment of claims. Willingly accepts responsibility ... optimal reimbursement for the hospital for services provided. Responsibilities: + Review chemo schedule in advance and determines patients insurance requirements for… more