- Penn Medicine (Philadelphia, PA)
- …hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management ... DME, placements, hospice, community resources, transportationQuality data collection and risk management referralWorks with patient and family to assure provision of… more
- Select Medical (Hummelstown, PA)
- …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... of the discharge planning process. + The primary job functions in Case Management include: + Clinical Interventions/Discharge Planning + Care Planning Management … more
- UPMC (Pittsburgh, PA)
- …in a human services field. + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... substance use disorder who have unstable, inadequate, or no residence. Intensive care management is provided in collaboration with the local housing vendor with whom… more
- UPMC (Pittsburgh, PA)
- …to LSW, LPC or CSW. + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... Mobile Professional Care Manager position to support the Population Health Case Management department. This is a Monday through Friday daylight role (8:00 am… more
- Geisinger (Shamokin, PA)
- …all Revenue Management teams and departments including Practice Consultants, Utilization Management and Care Management , Providers, Geisinger ... and out surgeries and outpatient clinical departments. + Follows Revenue Management policies and procedures regarding financial matters and payment arrangements. +… more
- Travelers Insurance Company (Harrisburg, PA)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically… more
- UPMC (Pittsburgh, PA)
- …with 6-8 year of experience. + 3 years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... Coordinates care and services across the continuum of care with case management , physicians, pharmacy, behavioral health, and other providers or health plan… more
- UPMC (Pittsburgh, PA)
- …Psychologist, LMFT or LPC + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... Coordinates care and services across the continuum of care with case management , physicians, pharmacy, behavioral health, and other providers or health plan… more
- UPMC (Pittsburgh, PA)
- …6-8 year of experience. + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... is seeking a full-time Mobile Professional Care Manager to support the Care Management Department in Beaver & Lawrence Counties! The Mobile Professional Care Manager… more
- Penn Medicine (Philadelphia, PA)
- …medical staff, and all areas of clinical documentation improvement, CEQI, denials management , coding, utilization management to develop and implement ... CDI, Coding, medical necessity, levels of care, care progression, denial management , compliance with governmental and private payer regulations, and appropriate… more