- UPMC (Coudersport, PA)
- …establish patients' plans of care in collaboration with physicians, patients, and utilization management (UM) professionals to meet physicians' orders and ... patients' needs. *RN will coordinate case management activities across a multi-disciplinary health care team to ensure appropriate, quality patient care. * Initiate,… more
- Humana (Harrisburg, PA)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health insurance ... organizations, hospitals and other healthcare providers, patient interaction, etc. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office… more
- Penn Medicine (Philadelphia, PA)
- …complete assigned tasks. (Corporate Services - HUP 3400 Spruce Street - Utilization Management ) **Responsibilities:** + Manages complex calendars with internal ... and external clients who are often in other time zones; resolves calendaring conflicts with minimal assistance. + Handles complex travel arrangements, itineraries, preparation and reconciliation of expense reports and advanced payments following health system… more
- Norstella (Harrisburg, PA)
- …or Specialty pharmacy. + Comprehensive knowledge of both pharmacy and medical benefit utilization management policies + Proven ability to exceed expectations and ... achieve goals + Excellent presentation and communication skills + Strong analytical and critical thinking skills + Strong organization skills with the ability to prioritize in a dynamic environment + Self-motivated with a strong "can do" attitude **Additional… more
- Evolent (Harrisburg, PA)
- …care, HIPAA, provider and vendor contracting, compliance, population health (including utilization management ), Medicare, and Medicaid. + Draft, review and ... negotiate contracts with providers, vendors, managed care customers, and other third parties to ensure compliance with applicable statutes, case law, governmental regulations and Evolent policy guidelines. Analyze and advise business owners of contractual… more
- Humana (Harrisburg, PA)
- …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health insurance ... organizations, hospitals and other healthcare providers, patient interaction, etc. + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine, PM&R, Anesthesiology and General Surgery clinical specialists **Work at Home Guidance** To… more
- St. Luke's University Health Network (Allentown, PA)
- …recommendations for process improvements and enhanced scheduling efficiency. + Technology Utilization : Utilize workforce management software and tools to ... labor regulations while optimizing coverage, fairness, and cost-effectiveness. + Shift Management : Manage and assign shifts based on employee preferences, seniority,… more
- Prime Healthcare (Bristol, PA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... in a Health and Human Services field is highly preferred. 2. Utilization Review/Case Management experience is highly preferred. 3. 1+ year of clinical experience… more
- Penske (Reading, PA)
- …involving cross-functional teams to support process improvements + Database tool utilization and management to drive process efficiencies + Utilize, ... mitigate future audit exposure + Other projects and tasks as assigned by management **Qualifications:** + Bachelor's degree is required + Project management +… more
- JB Hunt Transport (Mountain Top, PA)
- …participate in daily operational tasks including planning of freight; asset utilization ; safety management ; Department of Transportation (DOT) compliance; driver ... payroll; Customer Value Delivery; logistics management /analysis; driver supervision; profit-and-loss management ; maintenance coordination. + Gain understanding… more