- Genesis Healthcare (York, PA)
- …Five to seven years of clinical nursing experience is required. Prior experience in utilization review , case management or discharge planning is required. ... to develop the educational tools and materials that are needed to achieve care management goals. 9. Works collaboratively with the Director or Sr. Director… more
- Guthrie (Sayre, PA)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...and community providers. a) Works closely with the Medical Director and other members of the healthcare team to… more
- University of Pennsylvania (Philadelphia, PA)
- …wellness programs and resources, and much more. Posted 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... of prospects at the University. The Senior Prospect Management Analyst leads the departmental prospect utilization … more
- Genesis Healthcare (Mechanicsburg, PA)
- …The Director of Rehab is responsible for the efficient management of rehabilitation services in their assigned account(s). This position also assists ... Area Director ). 10. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and… more
- CDR Maguire (Allentown, PA)
- …skills. + Proven strategic planning and business development experience. + Financial management knowledge and ability to review and interpret financial ... Management of field staff within geographic region of...ESSENTIAL FUNCTIONS: Technical - As overseen by the PA Director of Construction Services and Construction Services Manager -… more
- CenterWell (Lancaster, PA)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- Commonwealth of Pennsylvania (PA)
- …experience performing this Work Behavior as a charge nurse, head nurse, utilization review nurse, quality assurance nurse, or an industrial, employee ... the Clinical Services Manager in the planning, organization, and management of both administrative and clinical operations within the...this Work Behavior as a charge nurse, head nurse, utilization review nurse, quality assurance nurse, or… more
- Penn Medicine (Philadelphia, PA)
- …(Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + Pennsylvania State Licensed ... to obtain pre-certification and assure reimbursement.Identify potential quality and utilization concerns and refer to the Director ...experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe… more
- Highmark Health (Pittsburgh, PA)
- …Organization's Formularies, utilization management programs, and disease management initiatives. + Provide clinical review and decisions including but ... . + Assist in the development and implementation of utilization management programs including but not limited...maximize overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. +… 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 ... the disease management agreement, including initial and ongoing validation of member...with the established personnel policies, and confers with the Director and Human Resources regarding the nature of the… more