- Wolters Kluwer (Harrisburg, PA)
- …including: + Conducting regular account review meetings and reviewing account utilization management reporting to provide recommendations + Overseeing contract ... front lines of clinical care. Our talented team of physician editors, technologists, and product visionaries collaborate to provide...+ Closely managing the deal through closure and keeping management informed of any risks or delays + Retaining… more
- WellSpan Health (York, PA)
- …provider groups to support contracting and enrollment efforts. + Partners with physician leadership, recruitment, and onboarding teams to ensure a seamless and ... mergers, and clinical integration efforts. + Leads optimalization and utilization of credentialing/enrollment software systems to support scalability and accuracy.… more
- UPMC (Pittsburgh, PA)
- …documentation within the medical record to ensure that all patient resource utilization , principal diagnosis, secondary diagnoses, and PCS procedures have been coded ... Meet appropriate coding productivity standards within the time frame established by management staff. + Code all diagnoses and procedures by assigning and verifying… more
- Select Medical (Mechanicsburg, PA)
- …and administration, approval, and signature. + Manage implementation of new contracts/renegotiations/ physician agreements. + Manage and act as corporate liaison for ... issues/resolution tracking.** + Serve as Hospital, payor relations, admissions, and case management support. + Promote use of Contract Information System and other… more
- Merck (North Wales, PA)
- …to characterize disease burden and epidemiology, treatment patterns, healthcare resource utilization and costs, physician and patient satisfaction surveys, ... Women's Cancer and contribute to value evidence strategies. Obtain senior management approval of evidence generation plans. Provide outcomes research leadership on… more
- Pfizer (Collegeville, PA)
- …and reporting, including RWD, Data Science, etc. **Vendor / Offshore Resource Management ** + Ensure team commissioning and contracting through preferred vendors + ... of flexible resources + Be accountable for continuous improvement and identification/ utilization of new capabilities to maximize the competitive advantages of the… more
- Sedgwick (Harrisburg, PA)
- …lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization ... college or university preferred. **Experience** Four (4) years of claims management experience or equivalent combination of education and experience required.… more
- UPMC (Mechanicsburg, PA)
- …one year experience in leadership required.KNOWLEDGE AND SKILLS:Expertise in care management , discharge planning and utilization review processes. Ability to ... + Functions as a resource person for the care management and denial management processes. Develops and...build credible and effective relationships with physician and executive leadership.Understanding of clinical, financial, and regulatory… more
- Health Advocates Network (Coal Township, PA)
- …shift. Charge nurses make assessments and decisions in regard to staff utilization and supplies and equipment needs. Charge nurse supervises paraprofessional and/or ... specialty care area, such as, infection control or quality assurance/improvement/risk management activities. Work assignments are received in the form of oral… more
- Geisinger (Danville, PA)
- …operations. Works in partnership with the Trauma Medical Director and Physician Liaisons to provide administrative and medical staff support. Organizes programs ... quality care for trauma patients, including clinical decision-making, resource utilization , and patient satisfaction. + Develops and implements clinical protocols… more