- Highmark Health (Pittsburgh, PA)
- …leadership team. The Physician Advisor is an integral part of the Utilization Management Committee and participates in hospital and enterprise-level quality ... Physician Advisor works in concert with the admitting physician, Case Management , and other hospital personnel, to...appeal letters and participates in data collection activities for utilization management . + Receives daily report from… more
- Genesis Healthcare (Williamsport, PA)
- …of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient ... of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification… 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 position also assists… more
- CenterWell (Lancaster, PA)
- …performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. ... the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …that facilitate access to prescription medications, including benefit verifications, non-clinical case management , prior authorization and appeal support, and ... "off grid" with leadership. Monitoring overtime to ensure cost-effective utilization + Organization Collaboration-Collaborates with program management to… more
- UPMC (Pittsburgh, PA)
- …PA. Preference will be given to candidates with a Pennsylvania RN license. The Utilization Management (UM) Care Manager is responsible for utilization review ... to providers as applicable. Consult with health plan medical director to discuss medical necessity for requested service. +...of 2 years of experience in a clinical and/or case management nursing required. + Work experience… more
- Deloitte (Harrisburg, PA)
- …PMs, Project Coordinators, etc. + 3+ years of project / program financial management (eg, Planning, Forecasting, Budgeting, Business Case Development, etc.) in ... and Managing Director leaders + Experience with strategy / business case development, then developing the implementation plan to support the business case… more
- St. Luke's University Health Network (Bethlehem, PA)
- …recommendations and actions. SUPERVISION (RECEIVED BY AND/OR GIVEN TO): Received: Pharmacy Management - Clinical coordinator, site director of pharmacy, network ... the hematology/oncology providers, and infusion centers to monitor chemotherapeutic utilization , supportive drug therapy utilization , adverse drug reactions,… more
- Trinity Health (Woodlyn, PA)
- …for 24-hour care delivery. + At the direction of the Medical Director reviews medical outcomes/statistical and utilization data, including reviewing of ... AND 1st Day Benefits **Position Purpose:** Under the supervision of the medical director , the Primary Care physician (PCP) provides primary medical care to PACE… more
- Geisinger (Scranton, PA)
- …Surgical units (Surgical Suite). Works in partnership with the Surgical Suite Director , Operations Managers, Materials Management Staff and Operating Room Team ... Leaders. Responsible for central sterile processing associates, material management , case cart preparation, scheduling, budget, financial management ,… more