- WellSpan Health (York, PA)
- …(acute and chronic), external pacer and temporary pacer, CRRT utilization , EKOS catheter-directed and ultrasound thrombolysis. **Department Summary** Surgical ... (acute and chronic), external pacer and temporary pacer, CRRT utilization , EKOS catheter-directed and ultrasound thrombolysis. **General Summary** Provides… 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 ... and development of new clinical policies and the regular review and updating of existing clinical policies as indicated.*...Care in a professional manner. * Responsible for efficient utilization of all resources including, but not limited to,… more
- JPMorgan Chase (Philadelphia, PA)
- …Manager is responsible for helping healthcare providers maximize the utilization and satisfaction with InstaMed products and services. **Job responsibilities** ... and collaboration. + Maximize revenue retention by identifying service and utilization trends, then developing and executing action plans to address the… more
- Geisinger (Wilkes-Barre, PA)
- …patient's reason for visit, weight, vital signs, visit screening information, medication review , and pertinent information for provider. + Sets up examination and ... substances only to ensure adequate supply levels, verify expiration dates, document utilization , optimize organizational efficiency and space utilization . + May… more
- Evolent (Harrisburg, PA)
- …role in **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This is an opportunity for a **Cardiologist** to ... cardiovascular programs that include improvements to clinical effectiveness of utilization management (UM) and risk-based models.** + Process improvement and… more
- WellSpan Health (Mount Gretna, PA)
- …care. + Coordinate with Case Management as indicated. + Participates in the review of policy and procedures on an ongoing basis providing evidenced-based revisions ... through monitoring patient outcomes. Assists with the collection and analysis of utilization patterns including avoidable days and denied cases; shares this with… more
- Travelers Insurance Company (Harrisburg, PA)
- …which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State regulations and medical ... guidelines to establish medical review policies. Works in close collaboration with the Claim...Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board… more
- CenterWell (Harrisburg, PA)
- …+ Monitor plan performance and proactively bring issues to the forefront for review + Support new business implementations with a goal of ensuring all pharmacy ... and present to client + Escalate issues for immediate review and action whenever necessary + Request, review...internal partners and the Medicaid market to manage pharmacy utilization and spend + Manage escalated member, client and… more
- Devereux Advanced Behavioral Health (Villanova, PA)
- …return on investment. + Internal operations support for referral review /admissions process (response times, acceptance rates, customer service and communication) ... of referrals to admissions related to admissions and operations/administrative barriers + Review referral packets on behalf of centers (reduce duplicative review… more
- Burns & McDonnell (Conshohocken, PA)
- …contracts, CM contracts, subcontracts, and change orders. + Participate in risk review process. + Implement assigned sections of the Project Execution Plan, ... of multiple global practices/disciplines, and facilitate the efficient cost-effective utilization of staff while adhering to contractual and performance… more