- UPMC (Pittsburgh, PA)
- …the CMA's collaborations, practical comprehension and hands-on experience in clinical care/ utilization management will result by collecting and assisting with ... + Assist clinical team with scheduling transportation, scheduling appointments, and tracking utilization . + Refer members to appropriate case management , health … more
- UPMC (Pittsburgh, PA)
- …PA. Preference will be given to candidates with a Pennsylvania RN license. The Utilization Management (UM) Care Manager is responsible for utilization review ... acute care, as needed. Coordinates with Health Plan case managers or health management staff members to follow-up after discharge from an inpatient setting. Provides… more
- Penn Medicine (Philadelphia, PA)
- …hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management ... must be a seasoned med/surg nurse with a minimum of 5 years' experience in Utilization review and 3 years of experience in the Transfer Center.** Summary: + Monitors… more
- Penn Medicine (Philadelphia, PA)
- …hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management ... community resourcesParticipates and drives accountability in daily interdisciplinary meetings Utilization Management :Adheres to guidelines to satisfy 3rd party… more
- Penn Medicine (Philadelphia, PA)
- …and workflow. + Oversee initiatives pertaining to physician and clinic schedule utilization and management to enhance access to all patients, providing ... funds and endowments, and research operations. Responsible for oversight and general management for the Division across all missions. The Sleep Medicine division is… more
- Commonwealth of Pennsylvania (PA)
- …term, long term, and strategic work plans to meet organizational and forest resource management goals, including the utilization and management of funds ... and strategic work plans to meet organizational and forest resource management goals, including the utilization and management of funds designated for area … more
- Highmark Health (Harrisburg, PA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Prime Therapeutics (Harrisburg, PA)
- …and works collaboratively with key internal stakeholders including Clinical, Clinical Program Management , and Utilization Management to deliver financial ... cliff opportunities + Serve as interdepartmental bridge between Trade, Clinical Program Management , Clinical, Utilization Management and other stakeholders… more
- St. Luke's University Health Network (Stroudsburg, PA)
- …, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among ... Manager, Per Diem coordinates the overall progression of care, resource utilization , and discharge planning for designated patient populations across the continuum… more
- St. Luke's University Health Network (Easton, PA)
- …for admission and/or referral to appropriate level of care. + May assist in the utilization management of psychiatric cases in the absence of the utilization ... and the Manager regarding variances, aspects of patient care management . + Facilitates insurance authorization, pre-certification, and concurrent reviews for… more