- University of Pennsylvania (Philadelphia, PA)
- …and housekeeping needs. Develops plans related to facility planning, space utilization and management , safety and accessibility requirements. Coordinates ... assess and mitigate current and future risk for the department, review risk management policies and procedures, and leads CPR/AED/First Aid certifications and… more
- Highmark Health (Harrisburg, PA)
- …expertise.This may include updating/revising existing medical policies. + Partner with Utilization Management and other operational teams to identify ... by internal/external partners. Conducts peer reviews as part of the quality review process. In addition to policy ownership, the incumbent participates in various… more
- XPO, Inc. (Allentown, PA)
- …service center + Oversee revenue, profit and cost controls + Ensure proper staffing, utilization and management of personnel + Mentor and manage all personnel ... qualifications: + 4 years of related work experience + Supervisory or management experience + Experience in the less-than-truckload (LTL) industry + Experience with… more
- UPMC (Pittsburgh, PA)
- …for the direct oversight of the day-to-day operations of the authorization, denial management , and/or utilization review functions of UPMC Revenue Cycle, ... responsibility. + Function as a resource person for authorization, denial management and/or utilization review processes. + Assess and respond to… 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 ... plans. The success of this role is determined by management of patients in hospital to ensure patients receive...patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with… more
- Wellpath (Lemoyne, PA)
- …or Care Management Certification. + RN preferred. Experience + Previous utilization review and/or case management and pre-certification experience + ... role** The Regional Care Manager (RCM) works collaboratively with the Utilization Medical Director, Regional Medical Directors, and Site Leadership to… more
- Penn Medicine (Philadelphia, PA)
- …pharmacy experience, including leadership responsibilities. + Strong knowledge of formulary management , drug utilization review , and cost-containment ... (PPMC). This leadership role oversees clinical pharmacy programs, formulary management , cost-containment strategies, and educational initiatives. The Coordinator will… more
- WellSpan Health (Chambersburg, 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
- Genesis Healthcare (York, PA)
- …is required. *Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and/or case management is highly desirable. *Must ... including case-mix, OBRA and OSRA required assessments. *Perform concurrent MDS review to insure appropriate RUGs category is achieved through the capture… more