- UPMC (Pittsburgh, PA)
- …role requires three years of coding experience. In this role, you will review clinical documentation within the medical record to ensure that all patient resource ... utilization , principal diagnosis, secondary diagnoses, and PCS procedures have...coding guidelines, third-party payer and OIG regulations. **Responsibilities:** + Review and evaluate focused UPMC DRG medical records for… more
- Penn Medicine (Lancaster, PA)
- …improvement initiatives that result in a measurable impact on quality, cost and resource utilization . * Partners with the manager to assure efficient and cost ... the child life perspective on hospital-wide committees. * Participates in the review , revision, and development of Policies & Procedures to reflect hospital and… more
- Highmark Health (Harrisburg, PA)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… 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
- JPMorgan Chase (Philadelphia, PA)
- …and payers for every healthcare payment transaction. The Customer Success Manager requires a self-motivated, problem-solving healthcare professional who wants to ... be challenged in a fast paced, team-oriented environment. The Customer Success Manager is responsible for helping healthcare providers maximize the utilization … more
- Guthrie (Sayre, PA)
- …knowledge by participation in continuing education, reading journals, resource utilization , vendor resources, and attending any required courses as observed ... by the manager . * Keeps manager , project teams, stakeholders,...the effective day‐to‐day operation of the systems and the review of system reports and responding to user requests… more
- Commonwealth of Pennsylvania (PA)
- …Your duties will include planning and organizing work under direction of Nurse Manager , as well as serving as a supervisor involved in planning, directing and ... with nursing services. You can expect to participate in the development, review , training and implementation of center policies and procedures. Additionally, you… more
- WellSpan Health (Mount Gretna, PA)
- …care. + Coordinate with Case Management as indicated. + Participates in the review of policy and procedures on an ongoing basis providing evidenced-based revisions ... through monitoring patient outcomes. Assists with the collection and analysis of utilization patterns including avoidable days and denied cases; shares this with… more
- Sargent Electric (Pittsburgh, PA)
- …The position will require some travel. GREAT BENEFITS PACKAGE!! RESPONSIBILITIES: + Review all purchase order and subcontract scopes and their relationship to ... project estimates, plans and specifications. Confirm with the Project Manager their completeness and accuracy. + Establish purchase order and subcontract priorities… more
- Guthrie (Sayre, PA)
- …physicians and patients. + Assist physicians in protocol development. + Advise department manager on resource utilization and training needs. + Perform other ... research facility or hospital setting. Essential Functions: + Collaborate with the manager and director for the development of department research programs. This is… more