- CenterWell (Harrisburg, PA)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Humana (Harrisburg, PA)
- …and leadership during Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical Coverage Policy ... develop and maintain medical coverage policies utilizing an evidence based medicine review process. **Location:** work at home anywhere Humana is seeking a Senior… more
- Ensono (Philadelphia, PA)
- …performance, reliability and consistency. + Increase efficiency through automation and/or template utilization as appropriate. + Review and seek out cost ... reductions, efficiency improvements and better methods to support applicable technology environments. + Keeps informed of latest industry, trends, products, services with relevant existing and emerging technologies. + Train and communicate with Associates and… more
- AECOM (Philadelphia, PA)
- …Qualifications** + 12 years of diverse experience in the rail industry Review Utilization . **Additional Information** All your information will be kept ... confidential according to EEO guidelines. + **Sponsorship is available for this position.** + **Relocation assistance is available for this position.** Offered compensation will be based on location and individual qualifications. The expected range is… more
- UPMC (Pittsburgh, PA)
- …policies of the Health Plan. + Actively participates in the daily utilization management and quality improvement review processes, including concurrent, ... to UPMC Health Plan members. They oversee adherence to quality and utilization standards through committee delegations and further establish an effective working… more
- Penn Medicine (Philadelphia, PA)
- …Employee Payroll - Review , edit, approve all timecards bi-weekly; review overtime utilization and manage appropriately, manage employee and physician ... schedules and time off requests. + Accountability - for Practice financials including: Practice expense and revenue variances, AR indicators including write-offs; maintain understanding and find root causes for variances. + Entity Compliance and Management… more
- Penn Medicine (Berwyn, PA)
- …+ Employee Payroll - Review , edit, approve all timecards bi-weekly; review overtime utilization and manage appropriately, manage employee and physician ... schedules and time off requests. + Accountability for Practice financials including: Practice expense and revenue variances, AR indicators including write[1]offs; maintain understanding and find root causes for variances + Entity Compliance and Management… more
- Republic Services (Scottdale, PA)
- …and monitor all required testing, including sampling of monitoring wells; monitors utilization of cover material; review soil reports and provide information ... to Environmental Manager. + Monitor and control all liquid and/or gas extraction systems on or around the landfill site. + Manage relationship with all outside contractors. + Establish productivity goals where needed; ensure adherence to operating standards;… more
- World Insurance Associates, LLC. (Philadelphia, PA)
- …care reform, HIPAA). + Lead the delivery of enrollment, benchmarking, financial and utilization data based on financial review standards and make recommendations ... knowledge of plan design alternatives, underwriting and funding concepts. + Drive utilization and ensure accuracy of all agency management system information for… more
- Colliers Engineering & Design (Philadelphia, PA)
- …and communicate effectively with all employees involved in the project to ensure high utilization rates (ie Project team meetings). + Review monthly man-hour and ... man power needed on projects. + Hold team meetings ensuring procedures governing review and approval of projects are followed prior to submission of completed work.… more