- WellSpan Health (Lebanon, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... to treatment. + For HBO: Evaluates the patient outcome and meets with the manager and the hyperbaric physician to discuss patient treatment and adjust treatment as… more
- RxBenefits (Philadelphia, PA)
- …channel management , B/G classifications, specialty designations, rebate eligibility, utilization trend, Utilization Management (UM) implications, ... Job Responsibilities Include: + Operate as the central project manager for the business on new opportunity prospects, playing...prospect member size, marketing agreements, broker commissions, and drug utilization . + Be the SME on dozens of medical… 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 nurse Manager / Director in his/her… more
- UPMC (Pittsburgh, PA)
- …of health insurance experience preferred. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... clinical and social history, current medications, geriatric syndromes, healthcare resource utilization , and case management interventions. Updates the plan of… more
- Genesis Healthcare (York, PA)
- …Respiratory Therapist is responsible for assisting the Vent Manager / District Manager in the efficient management of respiratory services in his/her assigned ... of the respiratory department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- Highmark Health (Harrisburg, PA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Organon & Co. (Plymouth Meeting, PA)
- …as well as other extended account team members to maximize appropriate utilization of Organon products. Integrates Senior Leadership into the overall business ... regional level, as required. Leads Organon 's efforts to maximize appropriate utilization of its portfolio while bringing resources and solutions to customers that… more
- UPMC (Pittsburgh, PA)
- …services related to clinical guidelines, coding requirements, regulatory requirements, and resource utilization . This role also acts as a SME for the department in ... representing management in meetings, training new staff and auditing peers....not limited to analysis of controlled substance prescribing and utilization to identify potential clinical care issues; prepayment review… more
- WellSpan Health (York, PA)
- …current programs and policies. Assumes the responsibilities of the Clinical Manager as designated. **Duties and Responsibilities** **Essential Functions:** + Related ... required.* Identifies un-met patient needs and reports findings to appropriate Clinical Manager .*Completes S1 and CRS as needed. Completes 4C with team members to… more
- St. Luke's University Health Network (Allentown, PA)
- …in order to facilitate a positive outcome for patients. + Assists in the utilization management of psychiatric patients. + Maintains clinical records of all ... + Provides case management duties as assigned by Supervisor. Case Management duties include individual assessments, utilization reviews, family or support… more
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