- St. Luke's University Health Network (Easton, PA)
- …patient care management. + Facilitates insurance authorization, pre-certification, and concurrent reviews for assigned patients. + Maintains clinical records ... the age of the patient treated. + Performs admission review on all inpatients. Attends daily patient rounds and...AND EXPERIENCE: At least 2 to 5 years of clinical experience providing care to patients with… more
- St. Luke's University Health Network (Orwigsburg, PA)
- …Performance Improvement Committees, Service line improvement teams and others. + Conducts concurrent review of the literature and websites to provide teams ... hire required. TRAINING AND EXPERIENCE: Minimum of 3-5 years' experience in clinical care of patients required. Experience preparing comprehensive written… more
- UPMC (Pittsburgh, PA)
- …Actively participates in the daily utilization management and quality improvement review processes, including concurrent , prospective and retrospective reviews, ... member grievances, provider appeals, and potential quality of care concerns. + Provide expedited review and...license. The ideal candidate will have 5-10 years of clinical experience, as well as managed care … more
- Wellpath (Lemoyne, PA)
- …month over month and a very large percent of those individuals receive direct clinical care , which includes lives saved by Narcan. We offer ongoing training ... best in class clinical resources for training, education, and point of care support. **How you make a difference** The Medical Director of Utilization Management… more
- Geisinger (Danville, PA)
- …biostatistician. Responsibilities include collaborating on the design of clinical research studies, writing biostatistical analysis plans for research ... of junior colleagues. They should possess a solid understanding of clinical research, excellent communication skills, work independently and ability to handle… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …the interdisciplinary treatment team planning process as well as complete and concurrent documentation in the medical record. The Psychiatrist will adhere to ... Manual of Mental Disorders, written treatment orders, admissions on-call review for all legal commitment status documents and ...and emergency Certificate of Need (CON) as required for care . Provide ongoing care and psychiatric evaluation… more
- Highmark Health (Pittsburgh, PA)
- …Employee Program (FEP) and Medicare Advantage. **ESSENTIAL RESPONSIBILITIES** + Coordinates the clinical care with the patient, family, physician(s), and other ... effectively. Our team of talented Case Managers aims to individualize health care to meet each patient's specific needs with a patient-centric and outcome-driven… more
- Prime Healthcare (Philadelphia, PA)
- …cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity ... The hospital has been serving the medical and health care needs of the Roxborough, Manayunk, East Falls and...of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3.… more
- UPMC (Erie, PA)
- …+ Attend and participate in Trauma QI activities such as MAC meetings. + Conduct concurrent review of trauma patient records within 48 hours of admission and ... heart of our trauma program. Your work empowers our clinical teams with the critical insights they need to...insights they need to drive continuous improvement in patient care . In return, we offer a comprehensive Total Rewards… more
- Prime Therapeutics (Harrisburg, PA)
- …**Responsibilities** + Provide end to end oversight and management of multiple concurrent , highly complex product initiatives + Collaborate with functional areas and ... + Ability to work well across cross-functional teams including clinical , network management, operations, specialty, client engagement, market segment services… more