• LPN Utilization Mgmt Reviewer - Medical…

    Guthrie (Troy, PA)
    Up to a $15,000.00 Sign on Bonus! Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other ... physician offices, and the Robert Packer Hospital Business Office,...Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of prior authorization/certification… more
    Guthrie (07/15/25)
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  • Regional Medical Director, Care Management…

    UPMC (Pittsburgh, PA)
    The Regional Medical Director, CC/DP and Utilization Review, provides clinical and management leadership across multiple hospitals within the region. This role ... focuses on improving patient flow, resource utilization , and length of stay (LOS) strategic oversight. The...The Regional Medical Director will have direct reports, including Physician Advisors at each hospital in their region. Key… more
    UPMC (07/11/25)
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  • Medical Director - Utilization Management

    UPMC (Pittsburgh, PA)
    The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Health Plan members. This fully remote role will be responsible for assuring physician commitment and delivery of comprehensive high quality health care to UPMC… more
    UPMC (06/12/25)
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  • Medical Director, Clinical Services

    Highmark Health (Harrisburg, PA)
    …Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician... utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and… more
    Highmark Health (07/29/25)
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  • Utilization Review RN Case Manager - Penn…

    Penn Medicine (Philadelphia, PA)
    …use of internal resources, communication with interdisciplinary care team and Physician Advisor, with timely coordination of home care, DME, placements, hospice, ... quality data collection and risk management referral. Responsibilities: + Utilization management activities: monitor appropriate use of internal resources,… more
    Penn Medicine (08/19/25)
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  • Director- Division Administration (Sleep Medicine)

    Penn Medicine (Philadelphia, PA)
    …optimization of provider experience and workflow. + Oversee initiatives pertaining to physician and clinic schedule utilization and management to enhance access ... underprivileged patients. + Provide guidance and assistance to optimize patient flow, utilization , and space design for clinical practices. + Working with the… more
    Penn Medicine (08/07/25)
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  • Echo/Vascular US Tech

    LifePoint Health (Roaring Spring, PA)
    …available to correlate with the study to be done. * Consults with referring physician to ensure appropriate utilization of services. * Regularly performs general ... procedures and personal role in disaster plan. * Participates in economical utilization of hospital resources. * Continually assists in revision and updating of… more
    LifePoint Health (08/09/25)
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  • Director, Physician Leadership - Medical…

    Humana (Harrisburg, PA)
    …role, you will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus ... health outcomes for some of our most vulnerable members. The Director, Physician leadership will lead Medical Directors performing utilization management for… more
    Humana (08/21/25)
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  • Physician - Chief Vascular Surgery Section

    Veterans Affairs, Veterans Health Administration (Philadelphia, PA)
    …students and residents within vascular services. Oversees Vascular specific time utilization to include appropriate prioritization of cases among all practitioners ... and other standards as applicable that guide that provider's practice. The physician will work in a team setting with other physicians, nurse practitioners,… more
    Veterans Affairs, Veterans Health Administration (08/10/25)
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  • Physician

    YesCare Corp (Philadelphia, PA)
    …_\#LI-DT1_ **Responsibilities** Below is a list of your responsibilities as a ** Physician ** with YesCare at Curran Fromhold Correctional Facility. We are seeking a ... night shift physician . + Provides typical community standard care based on...including sentinel event review. + Actively participant of the Utilization Review process and follow proper procedures. + Other… more
    YesCare Corp (06/05/25)
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