- AmeriHealth Caritas (Philadelphia, PA)
- …the performance standards embodied in the HEDIS program. + Assuring a high-performing Medical Management system that adheres to the terms of contracts and ... order to develop interventions to improve clinical effectiveness of medical management strategies. + Works closely with...Assists IHCM Managers in assessing members' need for case management services + Attends case management… more
- WellSpan Health (York, PA)
- WellSpan Medical Weight Management is seeking a dynamic Internal Medicine or Family Medicine physician who is board certified in Obesity Medicine. A good ... 20-minute follow-up. + May eventually develop a Pediatric Weight Management Program. **WellSpan Medical Group Offers:** +...Provide a broad range of diagnostic and therapeutic health services + Perform physical exams and health histories +… more
- Penn State Health (Reading, PA)
- …and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling. **WHY PENN STATE HEALTH MEDICAL GROUP?** ... veteran status, and family medical or genetic information._ **Position** Medical Office Associate - Pain Management **Location** US:PA:Reading | Clerical… more
- Guthrie (Sayre, PA)
- …Manager has the responsibility, accountability, and authority for coordinating the medical management of hospital patients, using outcomes-based approaches. The ... Director and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b)… more
- Highmark Health (Harrisburg, PA)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...**Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral &… more
- Humana (Harrisburg, PA)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
- Humana (Harrisburg, PA)
- …industry including Medicare Advantage and Managed Medicaid products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization,… more
- Humana (Harrisburg, PA)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
- UPMC (Media, PA)
- …+ Reviews the medical aspects of cost and utilization reports generated by Medical Management Information System. + Acts as a liaison for Community Care with ... a qualified individual to fulfill the role of Regional Medical Director in Delaware County, PA. The Regional ...Community Care members. This includes significant responsibility for quality management and utilization management and for assuring… more
- WellSpan Health (York, PA)
- …Days **General Summary** Provides safe, therapeutic and efficient care and services to patients. Assists in direct patient care, performs treatments, administers ... to lab. + Ensures all patient care areas are adequately stocked with unexpired medical supplies and has equipment that is in good working condition with up to… more