- Centene Corporation (Harrisburg, PA)
- …discharge planning + Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members and their families ... regrading BH utilization process + Interacts with BH healthcare providers as...abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
- Penn Medicine (Philadelphia, PA)
- …to share this rewarding and **REMOTE RN** role! This role will focus primarily on utilization review which is why we are seeking individuals who have between 3 to 5 ... quality data collection and risk management referral. Responsibilities: + Utilization management activities: monitor appropriate use of internal resources,… more
- CenterWell (Harrisburg, PA)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… more
- CenterWell (Harrisburg, PA)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
- St. Luke's University Health Network (Sellersville, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Utilization Review (UR) Assistant manages and obtains all funding for inpatient clients at ... the St. Luke's Penn Foundation Inpatient Recovery Center. JOB DUTIES AND RESPONSIBILITIES: + Manages the day-to-day insurance and funding reviews for all inpatient clients. + Performs continued stay and discharge reviews when needed. + Performs… more
- CenterWell (Harrisburg, PA)
- …care continuum. The incumbent will play a pivotal role in reducing acute care utilization for top 5% of complex patients and ensuring seamless transitions of care ... care facilities that ultimately improve care standardization and resource utilization , reduce readmissions and enhance/optimize patient outcomes, satisfaction, and… more
- WellSpan Health (Lebanon, PA)
- …4pm Weekend rotation **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of ... address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Duties and Responsibilities** + Reviews… more
- WellSpan Health (York, PA)
- …weekend requirement **General Summary** Performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of ... address patient discharge needs. Provides leadership in the integration of utilization and case management principles. **Essential Functions:** + Reviews assigned… more
- UPMC (Pittsburgh, PA)
- …and serves as an internal advocate of UPMC product standardization/ utilization initiatives. This individual coordinates new product introduction, product trials ... of supply availability disruptions (backorders/recalls). + Prepares product and service utilization reports and updates. + Monitors, implements and support … more
- Wolters Kluwer (Philadelphia, PA)
- …Customer Success Specialist plays a high-impact role in managing strategy and product utilization across the PHT product portfolio. They serve as an advisor for our ... are established and strengthened, drive product adoption and ensure utilization goals are achieved to maximize value realization, implementation projects… more