- Select Medical (Mechanicsburg, PA)
- …contract language, as well as following all internal controls for contract review and administration, approval, and signature. + Manage implementation of new ... contracts/renegotiations/ physician agreements. + Manage and act as corporate liaison...analysis reports. + Assist DBD's and CEO's in detail review and the analysis of actual-to-expected payor rate per… more
- UPMC (Pittsburgh, PA)
- …face-to-face assessments that include a clinical assessment and treatment, a review of the medical , functional, behavioral, pharmaceutical, and social ... face-to-face collaboration with members, their caregivers, and providers. Identifies members' medical , behavioral, and social needs, as well as barriers to care.… more
- ChenMed (Philadelphia, PA)
- …assess and record patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with inpatient staff for possible ... patient is in SNF, in conjunction with the post-acute physician , coordinates the transition to a lower level of...required + A minimum of one (1) year of utilization review and/or case management, home health,… more
- Penn Medicine (Philadelphia, PA)
- …conducts utilization management activities, communication with insurers, team, and physician advisor. Discharge planning activities such as : home care, DME, ... leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across… more
- WellSpan Health (York, PA)
- …the provider and the patient concerning patient. + In collaboration with Physician /APP, reinforces health education, counseling, and advice to patients and families ... will direct patient/caller to an acceptable alternative venue of care. Seeks Physician /APP advice appropriately. + Tracks, reviews, and monitors the follow-up of… more
- WellSpan Health (Lewisburg, PA)
- …the provider and the patient concerning patient. + In collaboration with Physician /APP, reinforces health education, counseling, and advice to patients and families ... will direct patient/caller to an acceptable alternative venue of care. Seeks Physician /APP advice appropriately. + Tracks, reviews, and monitors the follow-up of… more
- WellSpan Health (East Earl, PA)
- …the provider and the patient concerning patient. + In collaboration with Physician /APP, reinforces health education, counseling, and advice to patients and families ... will direct patient/caller to an acceptable alternative venue of care. Seeks Physician /APP advice appropriately. + Tracks, reviews, and monitors the follow-up of… more
- WellSpan Health (Ephrata, PA)
- …the provider and the patient concerning patient. + In collaboration with Physician /APP, reinforces health education, counseling, and advice to patients and families ... will direct patient/caller to an acceptable alternative venue of care. Seeks Physician /APP advice appropriately. + Tracks, reviews, and monitors the follow-up of… more
- Highmark Health (Monroeville, PA)
- …Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory ... etc. Serves as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer guidelines. Adheres to… more
- Penn Medicine (Philadelphia, PA)
- …must be a seasoned med/surg nurse with a minimum of 5 years' experience in Utilization review and 3 years of experience in the Transfer Center.** Summary: + ... leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across… more