- Healthfirst (PA)
- …and quality for each Specialist against expectations + Prepare cases for Medical Director Review ensuring that all pertinent information (ie case summary, ... in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management. + Demonstrated… more
- Fujifilm (Harrisburg, PA)
- …improve how we report on various activities. The role reports to the Director , Marketing & Communication in the Endoscopy division. **Company Overview** At FUJIFILM ... identifying activities, sponsorships, and equipment needed to ensure success. + Review and consideration of event participation levels and requirements, involving… more
- University of Pennsylvania (Philadelphia, PA)
- …Job Title Senior Prospect Management Analyst Job Profile Title Associate Director , Prospect Research Job Description Summary The Senior Prospect Management Analyst ... reports to the Director of Advancement Prospect Development and Research and is...Development and Research and is responsible for maximizing the utilization of prospects at the University. The Senior Prospect… more
- UPMC (Mechanicsburg, PA)
- …leadership required.KNOWLEDGE AND SKILLS:Expertise in care management, discharge planning and utilization review processes. Ability to build credible and ... Care Coordination and Discharge Planning Department under the direction of the Director . The Manager is accountable for achieving established goals and targets… more
- Arkema (Radnor, PA)
- …Date: Aug 16, 2025 SITUATION IN ORGANIZATION This position reports to the Director , Logistics, NA. Reporting to this position will be an Analyst and Specialist. ... to include market and industry analysis, supplier research and review , category and supplier segmentation, sourcing events, analysis, negotiations, contracting… more
- Fresenius Medical Center (Dallas, PA)
- …+ Develops action plans for unexcused and missed treatments in collaboration with the Director . + Plans, coordinates and acts as the liaison for patient care as per ... with the established personnel policies, and confers with the Director and Human Resources regarding the nature of the...+ Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic,… more
- Amergis (Pittsburgh, PA)
- …and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making ... of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical...pertinent to patient's needs/goals + Partners with the Program Director in development and review of the… more
- YesCare Corp (Philadelphia, PA)
- …measures including sentinel event review . + Actively participant of the Utilization Review process and follow proper procedures. + Other duties as ... need for non-formulary medication on non-formulary request form for Medical Director 's approval when non-formulary medication is ordered. + Utilizes available… more
- City of Pittsburgh (Pittsburgh, PA)
- …Specific Position Duties: In addition to the general position duties, the Development Review Principal Planner also: + Manages and supports the Zoning Board of ... Prepares letters, reports, decisions, testimony, and position papers for Planning Director , staff, Commissions, Zoning Board of Adjustment, etc. + Facilitates,… more
- Wellpath (Coal Township, PA)
- …and procedures for infirmary admissions, emergency room transfers, and the utilization review process for specialty referrals while maintaining responsibility ... They work under the supervision of the Site Medical Director and other site Physicians and in accordance with...provide required documentation of services to the Site Medical Director or designee in order to monitor provision of… more
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