- LifePoint Health (Johnstown, PA)
- …central Pennsylvania, serving over a half-million patients each year through the Conemaugh Physician Group and Medical Staff, a network of hospitals, specialty ... Conemaugh Physician Group is seeking a full-time Practice Manager...and Mount Aloysius College. *Why Choose Us:* * Health ( Medical , Dental, Vision) and 401K Benefits for full-time employees… more
- Penn Medicine (Philadelphia, PA)
- …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... includes all sites on and off campus. + Provide Physician leadership and partner with the CNO and Clinical...OR Executive Committees including but not limited to: OR utilization , patient access, revenue cycle, patient satisfaction and quality… more
- UPMC (Pittsburgh, PA)
- …The position will be fully remote! In this role, the DRG Specialist II will review clinical documentation within the medical record to ensure that all patient ... that were performed during an episode of care. + Review and evaluate focused UPMC DRG medical ...training on accurate DRG assignment for coding personnel, the medical staff, physician extenders (PAs, CRNPs), nursing… more
- Highmark Health (Pittsburgh, PA)
- …with operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims, coordination of benefits ... Allegheny General Hospital assists patients and their support systems in managing medical conditions effectively. Our team of talented Case Managers aims to… more
- WellSpan Health (Mount Gretna, 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
- UPMC (Pittsburgh, PA)
- …criteria (InterQual). + Ability to apply InterQual criteria appropriately. + Prior utilization review experience. + Knowledge of payer reimbursement structure. + ... facilitate payor/ physician contact when indicated. + Communicate to the Medical Directors, Attending Physicians and/or CFO, if indicated, regarding evaluation of… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …and/or services based on the needs of the organization; + Participating in utilization review activities including but not limited to development of standards, ... Chief Medical Officer to include providing necessary research or review ; + Participating in the established on-call rotation including weekdays, weekends, nights… more
- Penn Medicine (Philadelphia, PA)
- …optimization of provider experience and workflow. + Oversee initiatives pertaining to physician and clinic schedule utilization and management to enhance access ... leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across… more
- UPMC (Pittsburgh, PA)
- …patient information promptly. Collects and promptly processes demographic and medical necessity information. Participates constructively in the peer- review ... in adherence with established protocols and standards of care; accessing online medical command or other resources when appropriate, and employing the skills,… more
- ChenMed (Philadelphia, PA)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... need great people to join our team. ChenMed, a physician -led and mission-driven, primary care organization, is currently one...1 slot), CGCAHPS (patient experience), clinical gaps closures, and medical cost measures. Each PCP will have goals for… more