- Amgen (Pittsburgh, PA)
- …formulary adoption in targeted / assigned hospital accounts to help drive appropriate utilization of approved CV products; works with other sales colleagues to lead ... Representatives, District Sales Managers, Regional Sales Directors, Reimbursement/Access Specialists, Nurse Educators, Regional Marketing Managers, and the Value Based… more
- Trinity Health (Philadelphia, PA)
- …The Registered Nurse (RN) is responsible for providing oversight and management to the provision of service delivery to participants. Provide skilled nursing ... **Employment Type:** Part time **Shift:** **Description:** **Registered Nurse ** **Location: LIFE Broad Street, Philadelphia PA** **Status:** On-Call **Shift:**… more
- Sharecare (Harrisburg, PA)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- St. Luke's University Health Network (Allentown, 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
- Fresenius Medical Center (Pittsburgh, PA)
- …oversight of the position covers assigned treatment modalities (eg in-center, in-center and Home Modalities, or home hemodialysis and home peritoneal ... barriers to quality improvement. This includes promoting the adoption and utilization of Medical Advisory Board Recommended Algorithms and Standing Orders, clinical… more
- Lincoln Financial (Harrisburg, PA)
- …in a behavioral health setting including 1 year in claims, disability management (STD/LTD), worker's compensation, utilization review, and or behavioral health ... **Alternate Locations:** Charlotte, NC (North Carolina); Omaha, NE (Nebraska); Work from Home **Work Arrangement:** Remote : Work at home employee residing… more
- UPMC (Pittsburgh, PA)
- …or LSW, CSW or LPC. + 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 Allegheny County! The Mobile Professional Care Manager will work… more
- UPMC (Pittsburgh, PA)
- …inpatient auditing within our Coding Department. This position will be a work-from- home position working during standard business hours Monday through Friday. In ... documentation within the medical record to ensure that all patient resource utilization , principal diagnosis, secondary diagnoses, and PCS procedures have been coded… 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 ... + 6 years of experience in medical social work, home care, discharge planning, and case management ...years of hire to remain in role) + Registered Nurse (RN) Licensure, Certifications, and Clearances: + LSW, CSW,… more
- UPMC (Dubois, PA)
- …RN, LCSW, LSW, or LPC. + Three years of experience in behavioral, clinical, utilization management , home care, discharge planning, and/or case management ... community, with the remainder of the Care Manager's work completed remotely/from home ! Community Care Behavioral Health (CCBH) is committed to giving our neighbors… more
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