- WellSpan Health (York, PA)
- …tests (ie, INR results in Anticoagulation Clinic) under the collaboration of the Physician /APP. Assists in the management of patient care between visits. + ... and the patient concerning patient. + In collaboration with Physician /APP, reinforces health education, counseling, and advice to patients...Assists in the management of patient utilization of health care… more
- Centene Corporation (Harrisburg, PA)
- …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
- UPMC (Pittsburgh, PA)
- …policies of the Health Plan. + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, ... standards and professional developments in the areas of quality improvement and utilization management . + Communicate and educate network providers regarding… more
- UPMC (Media, PA)
- …care delivered to Community Care members. This includes significant responsibility for quality management and utilization management and for assuring the ... participation (directly or by designee) in the ongoing quality management and audit processes. + Interfaces with physician...MCOs. + Reviews the medical aspects of cost and utilization reports generated by Medical Management Information… more
- Gentiva (Canonsburg, PA)
- …with a schedule of 7on/7off.** The **Afterhours RN in our Advanced Illness Management (AIM) program** will report directly to the Director of AIM. Responsible for ... for the designated teams and functions as an interdisciplinary advanced illness management and support, along with telephonic, video, and in person interventions… more
- Grifols Shared Services North America, Inc (Pittsburgh, PA)
- …countries and regions. **Overview:** The primary responsibility of the Bleeding Management Hospital Specialty Sales Representative (HSSR) is to represent key ... products within the Bleeding Management product portfolio with a primary responsibility for the...relationships in institutions aligned with customer segmentation. + Develop physician influencer champions to submit and approve P&T requests… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …self-starter, enthusiastic personality. Three years of acute care experience in Care Management , Discharge Planning or Utilization management preferred. ... The ER Care manager will function as a liaison between attending physicians, Physician Advisors, local CCRCs, SNFs, PCFs, patients, families and community. The role… more
- Magellan Health Services (Somerset, PA)
- …Strong organization, time management and communication skills.* Knowledge of utilization management procedures, mental health and substance abuse community ... Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community… more
- UPMC (Washington, PA)
- …care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization /case management , discharge planning, Medicare, Medicaid, and ... The Manager oversees the day-to-day operations of the Case management department under the direction of the Director. The Manager is accountable for the following… more
- Highmark Health (Pittsburgh, PA)
- …Therapeutics Committee review. + Assist in the development and implementation of utilization management programs including but not limited to: prior ... account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and disease management initiatives.… more