- UPMC (Pittsburgh, PA)
- The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
- Humana (Harrisburg, PA)
- …will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus on ... The Director, Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director team… more
- UPMC (Pittsburgh, PA)
- …Advisors at each hospital in their region. Key Responsibilities + Leadership & Management **: + Oversee Utilization Management (UM) across assigned hospitals, ... effectively with hospital administration and clinical teams. + Experience in utilization management and care coordination. + In-depth understanding of… more
- Guthrie (Troy, PA)
- Up to a $15,000.00 Sign on Bonus! Summary The LPN Utilization Management (UM) Reviewer, in collaboration with Care Coordination, Guthrie Clinic offices, other ... physician offices, and the Robert Packer Hospital Business Office,...Hospital Business Office, is responsible for the coordination of Utilization Management (UM) processes and requirements of… 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
- Veterans Affairs, Veterans Health Administration (Philadelphia, PA)
- …of care as an integral part of the overall Medical Center quality management program. This includes participation in medical center meetings, VISN meetings and ... students and residents within vascular services. Oversees Vascular specific time utilization to include appropriate prioritization of cases among all practitioners… more
- St. Luke's University Health Network (Bethlehem, PA)
- …serve, regardless of a patient's ability to pay for health care. The Physician & Community Relations Representative represents the management , staff, and ... area physicians both in and outside St. Luke's Health Network. The Physician & Community Relations position links program resources to referring physicians,… more
- Trinity Health (Woodlyn, PA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Primary Care Physician ** Shift: Monday - Friday 8 am to 5:00 pm Status: Full time Location: ... the supervision of the medical director, the Primary Care physician (PCP) provides primary medical care to PACE Organization...of a disaster will know your disaster recovery, crisis management and business continuity plans and act within your… more
- Guthrie (Sayre, PA)
- …healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care... through ongoing interaction with the patient and family/caregivers, physician and other health care providers to achieve designated… more
- Guthrie (Sayre, PA)
- …aspects for Care Coordination including, but not limited to Case Management , Utilization Review (UR), Utilization Management (UM), and Medical Social ... of knowledge in and experience of payer contract language, as it relates to utilization management . Can navigate through the requirements imposed by all payers.… more