- Penn Medicine (Philadelphia, PA)
- …ensure lowest price paid. + Works to identify opportunities for standardization and utilization management within a product categories and potential to leverage ... Contract Manager collects and conducts analysis of spend data and other utilization data to identify expense reduction and operational improvement opportunities as… more
- CVS Health (Pittsburgh, PA)
- …will be responsible for overseeing the development, maintenance, and execution of utilization management programs. This will include both the clinical content ... needed to ensure the programs are implemented correctly. Knowledge of utilization management interventions including prior authorization, step therapy, quantity… more
- Evolent (Harrisburg, PA)
- …**What You'll Be Doing:** As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Evolent (Harrisburg, PA)
- …Doing:** As a Field Medical Director, Oncology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. .… more
- Humana (Harrisburg, PA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Select Medical (Erie, PA)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning, treatment plan management and financial… more
- UPMC (Pittsburgh, PA)
- …of health insurance experience preferred. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... clinical and social history, current medications, geriatric syndromes, healthcare resource utilization , and case management interventions. Updates the plan of… more
- Highmark Health (Harrisburg, PA)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- PPL Corporation (Allentown, PA)
- …and facilities space utilization . + Coordinates the maintenance and utilization of Facilities Management 's specific information system's needs, such as ... capital construction program for buildings. + Coordinates the acquisition and utilization of services for construction management , general constructions, and… more
- Geisinger (Danville, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... have prior RN experience in a hospital setting. Case Management experience is preferred and not required. The successful...of optimizing the patient or member's health status. Manages utilization and practice metrics to further refine the delivery… more
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