- UPMC (Pittsburgh, PA)
- …or adherence to payor medical policies. + Maintain collaborative relationships with utilization management and departments at payor organizations. + Provide ... in order to meet payor deadlines. + Report to management on an ongoing basis trends/barriers that could necessitate...+ Ability to apply InterQual criteria appropriately. + Prior utilization review experience. Knowledge of payer reimbursement… more
- Geisinger (Danville, PA)
- …and efficiency results for assigned population. + Works to appropriately apply benefits and utilization management serving as a resource to the patient or member ... Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for...all the necessary strategies to support length of stay management and throughput. It aligns the right care, at… more
- Penn Medicine (Lancaster, PA)
- …and the community as an expert in the field of wound and ostomy management . Patient care includes care to patients in the following age groups: neonatal, pediatric, ... + Evaluates and monitors effective skin care protocol and utilization of specialty beds. + Collaborates with the professional... of specialty beds. + Collaborates with the professional nurse directing the patient's care to assist in establishing… more
- WellSpan Health (York, PA)
- …surgery, arrhythmia monitoring and intervention, advanced cardiac life support, pacemaker/ICD management , IABP management , CRRT utilization , ventricular ... and according to the clinical standards of the hospital. Acts as a primary nurse for patients on the unit. Coordinates care planning with other disciplines. May… more
- Prime Therapeutics (Harrisburg, PA)
- …of post-degree clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + ... drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description** Under supervision, is responsible for performing referral… more
- WellSpan Health (Lewisburg, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation… more
- WellSpan Health (Lebanon, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation… more
- WellSpan Health (Mount Gretna, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation… more
- WellSpan Health (York, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation… more
- WellSpan Health (Lewisburg, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation… more