- Penn Medicine (Philadelphia, PA)
- …a strong patient advocate. The case manager conducts utilization management activities, communication with insurers, team, and physician advisor. Discharge ... hospice, community resources, transportation, and quality data collection and risk management referral. + Responsibilities: Utilization management … 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 ... plans. The success of this role is determined by management of patients in hospital to ensure patients receive...patient is in SNF, in conjunction with the post-acute physician , coordinates the transition to a lower level of… more
- UPMC (Pittsburgh, PA)
- …Advanced knowledge of applicable federal, state, and local laws as they pertain to physician BU management , preferred. + Knowledge of revenue cycle, physician ... agreements for BU. Provide direction and support to the BU management staff for clinical purchasing (pharmaceuticals, laboratory supplies, med-surgical supplies,… more
- Magellan Health Services (Newtown, PA)
- …Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community ... collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or… more
- Organon & Co. (Plymouth Meeting, PA)
- …Residency programs, Federally Qualified Health Centers, Universities, Independent Physician Associations, Management Service Organizations, Planned Parenthood ... Knowledge of Managed Care, State Medicaid, Managed Medicaid, Kaiser, Management Service Organizations, Group Purchasing Organizations, Independent Physician … more
- Penn Medicine (Lancaster, PA)
- …Department: Pharmacy and IV Solutions POSITION SUMMARY: In collaboration with the physician and other allied health professionals, evaluate drug therapy based on ... improve patient outcomes and reduce costs. + Utilizes assessment skills in the management of medically complex elderly to monitor responses to drug therapy. +… more
- UPMC (Pittsburgh, PA)
- …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan of care… more
- Humana (Harrisburg, PA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Penn Medicine (Philadelphia, PA)
- …workflow. + Oversee initiatives pertaining to physician and clinic schedule utilization and management to enhance access to all patients, providing ... funds and endowments, and research operations. Responsible for oversight and general management for the Division across all missions. The Sleep Medicine division is… more
- Humana (Harrisburg, PA)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more