- Geisinger (Wilkes-Barre, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... all the necessary strategies to support length of stay management and throughput. It aligns the right care, at...healthcare team. + Maintains required documentation for all case management activities. + Collects required data and utilizes this… more
- Trinity Health (Philadelphia, PA)
- …overall performance of the team including quality patient care, financial performance, utilization management , and compliance with state and federal regulations. ... Nurse in applicable state. Working knowledge in navigating through Excel and utilization of Outlook and Word. Excellent communication and problem solving skills.… more
- CenterWell (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a related field +… more
- Evolent (Harrisburg, PA)
- …billing and various sites of care/service + Familiarity with value-based care and utilization management + Understanding of data systems and the critical ... member-centric products. This role plays a critical part in both **Medical Cost Management ** and **Product Management ** , leveraging advanced analytics to solve… more
- Evolent (Harrisburg, PA)
- …critical role in **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This is an opportunity for a ... developing cardiovascular programs that include improvements to clinical effectiveness of utilization management (UM) and risk-based models.** + Process… more
- Evolent (Harrisburg, PA)
- …design and implement intuitive, efficient, and engaging user interfaces for our Utilization Management health care workflow applications. User research and ... with health care software development methodologies and lifecycles + Experience with utilization management and/or prior authorization processes is preferred +… more
- Intermountain Health (Harrisburg, PA)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... in examining patterns of health care needs, decisions, lifestyle choices, and utilization of resources that affect their health. + Advocates, educates and coaches… more
- WellSpan Health (Lewisburg, PA)
- …data analysis as required. + Develops and initiates educational programs regarding utilization management principles. + Attends meetings as required, and ... participates on committees as requested. **Qualifications** **Minimum Education:** + Bachelors Degree Must be degreed in social work or social welfare per PA Act 68 of 2008. Required **Work Experience:** + Less than 1 year Relevant experience. Required… more
- WM (Philadelphia, PA)
- …. Responsible for delivering excellence in cost, equipment availability, asset utilization , shop productivity management and performance improvements and fleet ... equipment is available to meet disposal operation requirements. Manage effective utilization of heavy equipment assets. Implement cost reduction, customer and… more
- Prime Therapeutics (Harrisburg, PA)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... cost solutions that meet the desired outcomes of the customer; general management of the account, including P&L responsibility; and accountability for contract… more