- AmeriHealth Caritas (Philadelphia, PA)
- … Review Home Modification Team and staff members within the LTSS Review Utilization Management Department. Responsibilities include providing technical ... us at www.amerihealthcaritas.com . **Responsibilities:** Under the supervision of the LTSS Manager /Director for Utilization Management , this position is… more
- Cardinal Health (Harrisburg, PA)
- **_What IT Software Supplier Management contributes to Cardinal Health_** IT Software Supplier Management provides strategic support and management of ... procurement (IDP), solution owners, enterprise architecture, finance, and software vendor management to mitigate commercial and legal risks and minimize the impact… more
- 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 ... and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation… more
- CenterWell (Harrisburg, PA)
- …of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review of the care received by members in an assigned region, ... practice management . + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managedMedicaid, or… more
- Highmark Health (Harrisburg, PA)
- …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create...**Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management … more
- Ryder System (Harrisburg, PA)
- …or if the Claim Manager is not available. Participates with Claim Manager in the selection and management of outside vendors for investigation, cost ... _Job Seekers can review the Job Applicant Privacy Policy by clicking...retained for investigations, cost containment, expert witnesses, and litigation management to ensure claims are being handled properly according… 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
- UPMC (Pittsburgh, PA)
- …+ Provide innovative ideas for new and existing clinical program development, utilization management , formulary management , provider education, and ... the pharmacy benefit. The Senior Clinical Pharmacist assists in managing pharmacy utilization and provides expertise in managing member care. These services will be… more
- Bank of America (Exton, PA)
- …Additional responsibilities may include client team training; supervisory responsibilities, including management of procurement or review teams; and/or ... Additional responsibilities may include client team training; supervisory responsibilities, including management of procurement or review teams; and/or … more
- Highmark Health (Harrisburg, PA)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and procedures while… more