- Penn Medicine (Philadelphia, PA)
- …quality data collection and risk management referral. Responsibilities: + Utilization management activities: monitor appropriate use of internal resources, ... community resourcesParticipates and drives accountability in daily interdisciplinary meetings Utilization Management:Adheres to guidelines to satisfy 3rd party payer… more
- Trinity Health (Darby, PA)
- **Employment Type:** Part time **Shift:** **Description:** **RN Care Manager - Utilization Management** **Location:** Mercy Fitzgerald **Department:** Care ... **Position Purpose** Mercy Fitzgerald is seeking a dedicated **RN Care Manager - Utilization Management** to join our Care Coordination team. Under the general… more
- Organon & Co. (Plymouth Meeting, PA)
- …Business Manager and be responsible for driving product awareness and utilization . The Territory Business Manager will work towards achieving and exceeding ... overall sales initiatives by developing effective relationships and partnering with physicians, working with staff, internal colleagues, and other pertinent parties within a defined territory. **Responsibilities** + Employ business planning and local market… more
- Guthrie (Troy, PA)
- …approaches and make recommendations for alternate levels of care. The Acute Case Manager also performs Utilization Management throughout the continuum of care in ... Acute Case Manager Position Summary: The Acute Case Manager...in an acute care setting with strong care management, utilization review, and payer knowledge. A Case Management certification… more
- Select Medical (York, PA)
- …high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, ... **Overview** **Critical Illness Recovery Hospital** **Case Manager ** **$5000 Sign On Bonus** _Requires a current...safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with… more
- Select Medical (Mckeesport, PA)
- …high-quality care and doing well by doing what is right. The Case Manager is responsible for utilization reviews and resource management, discharge planning, ... **Overview** **Critical Illness Recovery Hospital** **Case Manager (PRN)** _Requires a current licensure in a...safe and timely discharge plan. + Performs verification of utilization criteria reviews. + Builds relationships and coordinate with… more
- St. Luke's University Health Network (Bethlehem, PA)
- …including education and participation in identified projects as directed by Quality/Resource Utilization Manager . + Follows efficient and effective mechanisms to ... communicate opportunities for improvement to staff and trends to Managers and Directors. PHYSICAL AND SENSORY REQUIREMENTS: Exertional activity - Occasionally lift and/or carry 50 lbs. Frequently lift and/or carry 25 lbs. Being able to frequently lift or carry… more
- AmeriHealth Caritas (Philadelphia, PA)
- ; **Responsibilities:** The Medical Director, Utilization Management provides organizational leadership in the operational areas of care management, utilization ... and practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President, Medical Affairs. ;The following… more
- Baylor Scott & White Health (Harrisburg, PA)
- …Benefits may vary based on position type and/or level **Job Summary** As the Utilization Review RN you will review patient cases for medical necessity and establish ... in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care. + Excellent communication skills… more
- CenterWell (Harrisburg, PA)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more