- WellSpan Health (New Freedom, 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
- Geisinger (Scranton, PA)
- …+ Progressive Care Unit + Women's & Children's Perks of joining Geisinger as a Graduate Nurse ! + Offer GNs up to a year in advance - Can choose to receive ... on the specialized practice setting + Free Princeton NCLEX Review Questions (on-line, self paced)! + Temporary Practice Permit...starts available per month! + Automatic enrollment into our Nurse Residency Program - occurs during your entire first… more
- Evolent (Harrisburg, PA)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management … more
- ChenMed (Philadelphia, PA)
- …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as required that promote… more
- Penn Medicine (Lancaster, PA)
- …physiologic, psychological, and cognitive functions, through patient/provider office visits, nurse visits, and telephone triage. Collaborates with Physician and ... physiologic, psychological, and cognitive functions, through patient/provider office visits, nurse visits, and telephone triage. Collects and manages comprehensive… more
- Fresenius Medical Center (Dallas, PA)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Prime Healthcare (Bristol, PA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently ... accredited institution in a Health and Human Services field is highly preferred. 2. Utilization Review /Case Management experience is highly preferred. 3. 1+… more
- Guthrie (Sayre, PA)
- …experience: five (5) years of experience in an acute care setting with strong care management , utilization review , and payer knowledge. A Case Management ... levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care...in addition to a degree in Nursing. A registered nurse with five (5) years relevant experience willing to… more
- Penn Medicine (Philadelphia, PA)
- …+ 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + Pennsylvania State Licensed Nurse ... And 5+ years Prior experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe that the best care for our… more
- ChenMed (Philadelphia, PA)
- …years' clinical work experience required + A minimum of one (1) year of utilization review and/or case management , home health, hospital discharge planning ... through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care...patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with… more