- Penn Medicine (Lancaster, PA)
- … management platform/analytics. + Analyzes data to identify under/over utilization ; improve resource consumption; promotes potential reduction in cost and ... driver's license and daily access to an insured vehicle. **Preferred Qualifications** + Knowledge of Utilization review or managed care + Licensure with… more
- UPMC (Pittsburgh, PA)
- …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... to enhance their knowledge and skills related to health or lifestyle management . + Contact members with gaps in preventive health care services and assist them… more
- St. Luke's University Health Network (Allentown, PA)
- …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all ... Care Manager coordinates the overall progression of care, resource utilization , and discharge planning for designated patient populations across the continuum of… more
- Grifols Shared Services North America, Inc (Pittsburgh, PA)
- …specified "Account List" of Health Systems designed to increase the adoption and utilization of the Grifols Bleeding Management product portfolio. The KAM's ... role in the successful launch of a new Bleeding Management product within the Grifols Biopharma portfolio. The KAM...Utilization of all available educational resources to develop knowledge about products and disease states while also utilizing… more
- Guthrie (Sayre, PA)
- …staff, exhibiting the Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and leadership training within the ... / Director informed of clinical issues, triage problems, staffing issues, and risk management concerns. Acts on behalf of Clinical Manager / Director in his/her… more
- Select Medical (Mckeesport, PA)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with… more
- Highmark Health (Monroeville, PA)
- …party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization changes, contract ... or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - American Case … more
- ChenMed (Philadelphia, PA)
- …identifies functional status (ADLs and PT needs), discusses medications and self- management , identifies and corrects knowledge deficits. + Supports, collaborates ... + Performs other duties as assigned and modified at manager 's discretion. ** KNOWLEDGE , SKILLS AND ABILITIES:** +...required + A minimum of one (1) year of utilization review and/or case management , home health,… more
- Select Medical (York, PA)
- …by doing what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management ... within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with… more
- CenterWell (Lancaster, PA)
- …to sit on-site at our Lancaster, PA branch location.** The **RN Clinical Manager ** coordinates and oversees all direct care patient services provided by clinical ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts… more