- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners… more
- LifePoint Health (Johnstown, PA)
- …sufficient to provide and receive instructions/directions. **Job:** ** Case Management /Social Services* **Organization:** ** **Title:** *Market Director ... Growth Opportunities . And much more Position Summary: Provide Case Management leadership and management ... program.Ensure staff competencies in all areas of care management to include utilization review, transition/discharge planning,… more
- Guthrie (Troy, PA)
- Up to a $15,000.00 Sign on Bonus! Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other ... Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of...with members of the healthcare team. + Proactively researches case findings related to payer audits of UM decisions… more
- Genesis Healthcare (York, PA)
- …care management goals. 9. Works collaboratively with the Director or Sr. Director of Case Management to update strategic business plan and ensure ... In conjunction with the Director or Sr. Director , acts as case management ...of clinical nursing experience is required. Prior experience in utilization review, case management or… more
- Guthrie (Sayre, PA)
- …clinical approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the ... , utilization review, and payer knowledge. A Case Management certification or obtaining a ...and community providers. a) Works closely with the Medical Director and other members of the healthcare team to… more
- UPMC (Washington, PA)
- The Manager oversees the day-to-day operations of the Case management department under the direction of the Director . The Manager is accountable for the ... identified needs of Case Management staff + Assists with management of departmental budget. + Collaborates with Director , Medical Director /Physician… more
- Humana (Harrisburg, PA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Humana (Harrisburg, PA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Humana (Harrisburg, PA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a… more
- Humana (Harrisburg, PA)
- …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more