- Highmark Health (Pittsburgh, PA)
- …Physicians, Case Managers, UM nurses, and the hospital leadership team. The Physician Advisor is an integral part of the Utilization Management Committee ... Advisor works in concert with the admitting physician , Case Management , and other hospital personnel,...appeal letters and participates in data collection activities for utilization management . + Receives daily report from… more
- Huntington National Bank (Pittsburgh, PA)
- Description Job Summary: As a Treasury Management Advisor III - Corporate Healthcare, you will play a pivotal role in driving the growth and success of our ... In this role, you will act as a trusted advisor to both clients and prospects, providing insightful guidance...: Oversee portfolio performance, ensuring revenue growth and high utilization of treasury solutions + Risk Management … more
- UPMC (Media, PA)
- …care delivered to Community Care members. This includes significant responsibility for quality management and utilization management and for assuring the ... MCOs. + Reviews the medical aspects of cost and utilization reports generated by Medical Management Information...and maintains effective relationships with providers. + Serves as physician advisor for UPMC Passavant McCandless and… 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
- UPMC (Washington, PA)
- …with management of departmental budget. + Collaborates with Director, Medical Director/ Physician Advisor and staff to ensure effective processes and systems ... care/treatment, The Joint Commission Standards, Federal/State regulations relative to utilization /case management , discharge planning, Medicare, Medicaid, and… more
- Penn Medicine (Philadelphia, PA)
- …being a strong patient advocate. The case manager conducts utilization management activities, communication with insurers, team, and physician advisor . ... appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor , with timely coordination of home care, DME,… more
- Penn Medicine (Philadelphia, PA)
- …appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor , with timely coordination of home care, DME, ... hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management … more
- Highmark Health (Monroeville, PA)
- …for denial trends with the care coordination teams, performance improvement teams, physicians/ physician advisor and third party payers. + Maintains a working ... knowledge of care management , care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.… more
- UPMC (Pittsburgh, PA)
- …requirements. + Takes leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor , Attending Physicians and clinical ... (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and… more
- Penn Medicine (Philadelphia, PA)
- …appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor , with timely coordination of home care, DME, ... hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management … more