- Globus Medical, Inc. (Audubon, PA)
- …inventory is required to support surgical cases, ensuring coverage and efficient asset utilization . + Review and process Loaner Extension Requests. + Coordinate ... support proper allocation to meet case demands. + Maximize consignment inventory utilization in line with Scorecard goals. + Support management of company inventory… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …telepsychiatry services based on the needs of the organization; d. Participating in utilization review activities including but not limited to development of ... Manual of Mental Disorders, written treatment orders, admissions on-call review for all legal commitment status documents and ...review for all legal commitment status documents and review and completion of routine and emergency Certificate of… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …and/or services based on the needs of the organization; + Participating in utilization review activities including but not limited to development of standards, ... history and physical examination, either written or dictated. This includes a review of the immunization status, allergies, past history, family history and… more
- YesCare Corp (Philadelphia, PA)
- …including sentinel event reviews and chart audits. + Engage actively in the Utilization Review process, ensuring appropriate use of healthcare resources. **Key ... + Provide and ensure on-call services to support patient care needs. + Review and approve clinical protocols, policies, procedures, and the medical disaster plan… more
- Prime Therapeutics (Harrisburg, PA)
- …licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations etc.); compile ... administering the annual conflict of interest process, or completing regular review of standard operating procedures and policies; may develop annual revision… more
- Prime Therapeutics (Harrisburg, PA)
- …licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations, etc); compile ... of interest or other cyclical compliance processes, or implementing a regular review cadence for standard operating procedures (SOP) and policies + Research and… more
- Wellpath (Fayette County, PA)
- …staff and ensure adherence to clinical protocols + Oversee chronic care clinics, utilization review , and quality improvement initiatives + Collaborate with the ... key role in chronic care clinic oversight, pharmacy monitoring, and medical program review . **What you bring to the table** EDUCATION + Medical school graduate… more
- Highmark Health (Harrisburg, PA)
- …cases, which may involve speaking with providers via phone.At times, build cases in Utilization Review system during high volume times. + May have responsibility ... audit issues to determine root cause of errors and recommend process improvements. Review error trends to identify training opportunities. + Other duties as assigned… more
- Insight Global (Philadelphia, PA)
- …pain management protocols. Maintain accurate documentation, including notes, reports for utilization review , and appeals (training provided). Manage a caseload ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …preferred. + Experience in a combination of home care management, case management review , utilization review , social service support, insurance reimbursement ... and patient advocacy, preferred. + In-depth understanding of health care insurance benefits, relevant state and federal laws and insurance regulations, highly desired. + Experience with data entry/computer literate skills, preferred. + Exhibits a high level of… more