- Guthrie (Sayre, PA)
- …Experience: + Two years of recent clinical supervisory experience or charge nurse experience desired Essential Functions: + RESOURCE UTILIZATION ; Considers ... Manager / Director informed of clinical issues, triage problems, staffing issues, and risk management concerns. Acts on behalf of nurse Manager / Director in… more
- ChenMed (Philadelphia, PA)
- …clinical work experience required + A minimum of one (1) year of utilization review and/or case management , home health, hospital discharge planning experience ... through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care...plans. The success of this role is determined by management of patients in hospital to ensure patients receive… more
- Select Medical (Hummelstown, PA)
- …venture with Select Medical & Penn State Health** **Director of Quality Management ** **(DQM)** **$10,000 Sign-on bonus** + Bonus incentives + Extensive onboarding ... amputation, and multiple traumas **Responsibilities** Coordinates the Medical Quality Management and Performance Improvement activities to measurably enhance the… more
- Guthrie (Towanda, PA)
- …hire. Experience: Two years of recent clinical supervisory experience or charge nurse experience desired Essential Functions: 1.RESOURCE UTILIZATION : + Considers ... Position Summary: In collaboration with the management team focuses on daily department operations. Supervises personnel and coordinates activities of Nursing.… more
- Select Medical (Erie, PA)
- … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW...what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,… more
- Highmark Health (Jefferson Hills, PA)
- …effective resource utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization , and patient/family ... Incumbents will utilize nationally recognized standards of practice for case management by collaborating with providers, clinical teams, health plans, and external… more
- Highmark Health (Monroeville, PA)
- …and third party payers. + Maintains a working knowledge of care management , care coordination changes, utilization review changes, authorization changes, ... relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care and manages… more
- UPMC (Pittsburgh, PA)
- …services related to clinical guidelines, coding requirements, regulatory requirements, and resource utilization . This role also acts as a SME for the department in ... representing management in meetings, training new staff and auditing peers....not limited to analysis of controlled substance prescribing and utilization to identify potential clinical care issues; prepayment review… more
- YesCare Corp (Philadelphia, PA)
- …requested. + Participate in quality care reviews and sponsor physician assistants or nurse practitioners as needed. + **Schedule Management :** Notify the Site ... Care:** Deliver evidence-based clinical services, including sick calls, chronic care management , history and physicals, and emergency care. + Visit the infirmary… more
- Penn Medicine (West Chester, PA)
- …to systemwide Value Analysis Councils. Acting as a liaison among Materials Management , Physicians, Clinical Groups, Supply Chain, and System Leadership, the position ... and consultation. It also oversees service line VACs, supporting standardization, utilization , and new product assessments, while coordinating closely with supply… more