- UPMC (Pittsburgh, PA)
- …collaborate effectively with hospital administration and clinical teams. + Experience in utilization management and care coordination. + In-depth ... The Regional Medical Director , CC/DP and Utilization Review, provides clinical and management ...documentation of all physician advisory activities in the UPMC Care Management information system. + Conduct or… more
- Humana (Harrisburg, PA)
- …depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Harrisburg, PA)
- …depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Harrisburg, PA)
- …depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned ... with prior experience participating in teams focusing on quality management , utilization management , case ...business metrics. + Experience working with Case managers or Care managers on complex case management , including… more
- UPMC (Pittsburgh, PA)
- The Medical Director , Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
- Wellpath (Lemoyne, PA)
- …and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization review, ... to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a… 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, ... Packer Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior… more
- UPMC (Pittsburgh, PA)
- …patient care through innovation? UPMC Nursing is seeking a dynamic Director , Virtual Care Center to launch enterprise-wide virtual nursing initiatives. In ... centralized cardiac monitoring unit and other aspects of virtual care programs. The Director is responsible for.... + Develops and implements new areas of clinical utilization for all Virtual Care programs. +… more
- UPMC (Media, PA)
- …to Community Care members. This includes significant responsibility for quality management and utilization management and for assuring the adequacy ... the provider network for the clinical needs of Community Care members. The Medical Director also participates...a regional perspective. + Supports member satisfaction with the care management process. + Implements quality … more
- Highmark Health (Natrona Heights, PA)
- …:** **GENERAL OVERVIEW:** Provides operational and strategic leadership for Hospital/facility Care Management Department. Collaborates with nursing and clinical ... level of care determination practices. (20%) + Studies and implements the care management model and structure to achieve sustainable length of stay, resource… more