- St. Luke's University Health Network (Allentown, PA)
- …admission and/or referral to appropriate level of care. + May assist in the utilization management of psychiatric cases in the absence of the utilization ... degree in Social Work or Counseling or related field. EDUCATION: Registered Professional Nurse with a current license to practice in the state of Pennsylvania.… more
- WellSpan Health (York, PA)
- …individual staff to ensure safe quality care, progress towards goals, and proper utilization of services. * Provides after-hours and on-call staff support as well as ... Care in a professional manner. * Responsible for efficient utilization of all resources including, but not limited to,...emphasis in home care. Preferred **Licenses:** + Licensed Registered Nurse Upon Hire Required + Heartsaver CPR/AED Upon Hire… more
- Highmark Health (Pittsburgh, PA)
- …with operational areas regarding issues related to supported technology. Manage utilization review, translation of foreign claims, coordination of benefits (COB), ... benefits/requirements/limits, discharge planning requirements, length of stay and resource utilization issues. + Adheres to the policies, procedures, rules,… more
- Highmark Health (Harrisburg, PA)
- …itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education ... education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment and… more
- WellSpan Health (Chambersburg, PA)
- …effectively manager cost and maximize employee satisfaction and resource utilization . **Duties and Responsibilities** **Essential Functions:** + Facilitates and ... + Creates customized reports to present data valuable to logistics manager, nurse managers, department directors, and finance partners for resource management. +… more
- Penn Medicine (Lancaster, PA)
- …physician, nurse and patient regarding the contents, therapeutic action, utilization and possible adverse reactions or interactions of medication. + Responds to ... teaching aides or computer-generated warning or supplemental information. + Conducts drug utilization reviews to assure the quality of drug use. Determines if… more
- Amergis (Pittsburgh, PA)
- …continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential ... and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients in decision-making for… more
- Geisinger (State College, PA)
- …substances only to ensure adequate supply levels, verify expiration dates, document utilization , optimize organizational efficiency and space utilization . + May ... Minimum of 1 year-Nursing (Preferred) Certification(s) and License(s) Licensed Practical Nurse - Default Issuing Body; Basic Life Support Certification - Default… more
- Penn Medicine (Lancaster, PA)
- …physician, nurse and patient regarding the contents, therapeutic action, utilization and possible adverse reactions or interactions of medication. + Responds to ... teaching aides or computer-generated warning or supplemental information. + Conducts drug utilization reviews to assure the quality of drug use. Determines if… more
- UPMC (Pittsburgh, PA)
- …Clinical Documentation Improvement (CDI) experience. + Background in Quality Assurance, Utilization Review, or Quality Insights. + Advanced knowledge of DRGs, PPS, ... certifications and licensure. + Certified Coding Specialist (CCS) OR Certified Registered Nurse Practitioner OR Doctor of Medicine (MD) OR Doctor of Podiatric… more
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