- Guthrie (Troy, PA)
- … for hospital inpatient admissions and short procedures by translating clinical information to Utilization Management requirements using pre‐determined criteria. ... appropriate institutional, community, or specialized resources. 4) Integrates patient information , clinical /financial/operational data and evaluates the impact… more
- Highmark Health (Pittsburgh, PA)
- …+ Prepares (or oversees the preparation of), presents and interprets complex clinical information to key stakeholders, including clinical leadership, ... Officer, the VP, Quality Informatics and Reporting, and administrative and clinical leaders for each entity within Allegheny Health Network's (AHN) enterprise.… more
- Humana (Harrisburg, PA)
- …environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some ... , requested level of care, and/or requested site of service should be authorized. All work occurs with a...clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director… more
- UPMC (Pittsburgh, PA)
- …coverage. A Precert Care Manager is responsible for documenting and reviewing clinical information and making authorization determinations for adult and ... and knowledge. Works as part of a team providing clinical expertise and knowledge to member services ...Independently problem solves based on advanced-level knowledge of the service delivery system, clinical treatment, diversion resources,… more
- Penn Medicine (Philadelphia, PA)
- …positive relationships with building owner, construction, township and other personnel, as needed. + Clinical Service Groups & Product Service Lines - As ... practice complexity): multiple practice locations, high practice/facility square footage, service line oversight, coordination of inpatient services ,… more
- Penn Medicine (Philadelphia, PA)
- …positive relationships with building owner, construction, township and other personnel, as needed. Clinical Service Groups & Product Service Lines - Supports ... practice complexity): multiple practice locations, high practice/facility square footage, service line oversight, coordination of inpatient services ,… more
- Humana (Harrisburg, PA)
- …have regular discussions with external providers by phone to gather additional clinical information and discuss determinations. Medical directors are expected to ... uses their medical background, experience, and judgement to make determinations whether requested services , level of care, and/or site of service should be… more
- Penn State Health (Hershey, PA)
- …at each PSH hospital, and proximity to the patient's home community. + Collect clinical information to determine patient's level of care while collaborating with ... transportation arrangements and provide an assigned bed. + Communicate clinical information to transportation company, physicians, physician designees,… more
- Takeda Pharmaceuticals (PA)
- …systems and specialty medical practices. + Presents complex clinical and business information on Takeda's specialty products and services to an audience of ... customers across a brand belief continuum. + Support initial clinical educational support and in- service for medical...and deliver a targeted sales message based on accurate clinical information , utilizing approved marketing materials and… more
- UPMC (Pittsburgh, PA)
- …as indicated. + Completes clinical documentation on the same day of service delivery and provides clinical information to patient access representative ... The purpose of this job is to provide independent clinical treatment services to the targeted populations....populations. This is an outpatient treatment program designed to service patients with a mental health diagnosis who meet… more