- Sharecare (Harrisburg, PA)
- …nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during ... unify and manage all their health in one place. Our comprehensive and data -driven virtual health platform is designed to help people, providers, employers, health… more
- UPMC (Pittsburgh, PA)
- UPMC Community Care Behavioral Health is hiring full-time Quality Management Specialists! This position involves extensive travel throughout Pennsylvania, with ... need to reside within 2 hours of a CCBH office location. The Quality Management Specialist is responsible for performing functions related to quality management … more
- Highmark Health (Natrona Heights, PA)
- …OVERVIEW:** Provides operational and strategic leadership for Hospital/facility Care Management Department. Collaborates with nursing and clinical leaders ... (20%) + Directs and oversees all activity related to referral management .Leverages Epic and Careport/Allscripts data to assess effectiveness.Collaborates closely… more
- ICON Clinical Research (Blue Bell, PA)
- …CRO experience is a non-negotiable requirement. + Extensive experience in project management within the clinical research or pharmaceutical industries. + ... Senior Manager, Project Management - Imaging - Remote, US ICON plc...US ICON plc is a world-leading healthcare intelligence and clinical research organization. We're proud to foster an inclusive… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director, CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This role ... building. + Proven ability to collaborate effectively with hospital administration and clinical teams. + Experience in utilization management and care… more
- Humana (Harrisburg, PA)
- …first** The UM Strategy team is a multi-disciplinary team focused on creating data -driven strategies to transform our business and the experiences we create for our ... concrete roadmaps that will generate tangible value to all stakeholders. Within Utilization Management , our goal is to enable members to receive the most appropriate… more
- Highmark Health (Blue Bell, PA)
- …processes and reporting that ensure complete and timely correction and resubmission of data errors from CMS 5. Vendor Management + Manage relationship and ... :** **GENERAL OVERVIEW:** This position is responsible for risk revenue management for all government program products (commercial ACA, Medicare, and Medicaid).… more
- Wolters Kluwer (Philadelphia, PA)
- …Health Clinical Effectiveness team, the Associate Director, Technology Product Management , role for Medi-Span will govern assigned areas of the Medi-Span Product ... for assigned areas in Medi-Span by closely collaborating with Engineering, Clinical Content, Product Management , Systems Implementation, Customer Support,… more
- Guthrie (Sayre, PA)
- … for decision making, PI planning, and strategic planning + Responsible for the clinical Utilization Management component of the Revenue Cycle + Assures UM ... Position Summary: Provides leadership and management of all operational aspects for Care Coordination...related to UM team process + Monitors/evaluates resource use ( data ) and implements performance improvement as necessary (ie LOS,… more
- St. Luke's University Health Network (Orwigsburg, PA)
- …The Director, Quality and Patient Safety is responsible for all aspects of Quality, Clinical Risk Management and Patient Safety for their assigned entity. This ... decile performance and outcomes. + Promptly investigates actual and potential adverse clinical events at assigned entity, including those reported via the Patient… more