- Fresenius Medical Center (Pittsburgh, PA)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. ... a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in...+ Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. +… more
- Cognizant (Harrisburg, PA)
- …guidelines and regulations + Experience in the analysis and processing of claims, utilization review /quality assurance procedures + Must be able to work with ... Based** Claims Processors to join our growing team. The ** Medical ** **Claims Processor** is responsible for the timely and...HCFA paper, or EDI information. + Responsible for reviewing medical records when necessary to determine if the service… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …to work and adjust to different environments. Knowledge of Interqual and utilization review standards. Experience in clinical documentation within electronic ... required. Experience in Care Coordination, Discharge Planning, Clinical Documentation and Utilization Review preferred. Strong verbal, written and leadership… more
- Fresenius Medical Center (Dallas, PA)
- …communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with ... as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. +… more
- Guthrie (Sayre, PA)
- …and autonomy in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... serve as a practice support in the Patient Centered Medical Home development and process. The position is an...position is an integral part of the Patient Centered Medical Home Team. The PCMH Care Coordinator has the… more
- Guthrie (Sayre, PA)
- …not limited to Case Management, Utilization Review (UR), Utilization Management (UM), and Medical Social Work. Provides leadership for interdisciplinary ... performance improvement activities throughout the organization and for the medical staff. Responsibilities include Robert Packer Hospital, Robert Packer Hospital… more
- Health Advocates Network (Harrisburg, PA)
- …setting, behavioral health setting, drug and alcohol setting, managed care, quality management/ utilization review or other related clinical experience; or An ... (MA), health care services, human services, long term care, utilization review , or knowledge of home care...review . Role Description: This is work in the review and evaluation of the medical necessity,… more
- WellSpan Health (Chambersburg, PA)
- …and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation ... of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education relative to health care… more
- UPMC (Pittsburgh, PA)
- …you have an interest in health insurance, but thrive on working in a medical office setting with face-to-face interaction with the members you are caring for? UPMC ... and 82 and there are multiple nearby paid parking options include Luna Garage, Medical Center Garage, and the Aiken Ave Employee Garage. As a Clinical Care Manager,… more
- UPMC (Pittsburgh, PA)
- …AMA FREIDA). + Coordinate and maintain documentation pertaining to the UPMC Medical Education Annual Program Oversight Review (APOR) and anticipated required ... to ensure that the training program is in full compliance with UPMC, UPMC Medical Education (ME), and Accrediting Body (ACMGE, AHSP, CODA, or CPME) policies and… more