- Commonwealth of Pennsylvania (PA)
- …family-centered services. Your role will involve scheduling and facilitating case review meetings, coordinating specialized teams to meet specific needs of children ... and objectives by reviewing documentation such as strategic plans, service utilization and development reports, and financial reports; compiling findings to assess… more
- Penn Medicine (West Chester, PA)
- …and consultation. It also oversees service line VACs, supporting standardization, utilization , and new product assessments, while coordinating closely with supply ... + Meets regularly with hospital leadership and management to review product/equipment/supply issues and provide updates on resolution to known… more
- Humana (Harrisburg, PA)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Humana (Harrisburg, PA)
- …Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical management review organization ... us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments… more
- Highmark Health (Harrisburg, PA)
- …both internally developed and vendor-sourced criteria. This includes proactive monitoring, review , and timely updates in response to new evidence, regulatory ... data-driven insights from complex healthcare datasets (eg, claims, clinical, utilization , pharmaceutical) to inform policy development, identify areas for… more
- Penn Medicine (Philadelphia, PA)
- …quality data collection and risk management referral. Responsibilities: + Utilization management activities: monitor appropriate use of internal resources, ... resources + Participates and drives accountability in daily interdisciplinary meetings Utilization Management: + Adheres to guidelines to satisfy 3rd party payer… more
- CSL Behring (King Of Prussia, PA)
- …provider levels. + Secures meetings with appropriate customer personnel to review the clinical and reimbursement information and adopt appropriate treatment ... with business teams, marketing and medical affairs to ensure alignment and full utilization of resources at account level. This includes utilization of marketing… more
- Teledyne (Collegeville, PA)
- …at the operation site. + Execute the daily production schedule through the utilization of people, materials, and processes to meet the customer needs, schedules, ... out to be tested. + Process service entry sheets. + Manage employee utilization sheets. + Conduct quarterly and annual reviews with employees regarding set goals… more
- PPL Corporation (Allentown, PA)
- …not limited to, financial target dissemination among functions/departments, full utilization of labor resources, identification of support function labor ... mechanism/tracker filings as well as other filings as required. + Review and perform day-to-day accounting and budgeting functions including project/work order… more
- CVS Health (Harrisburg, PA)
- …and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of ... Members: Through the use of clinical tools and information/data review , conducts comprehensive assessments of referred member's needs/eligibility and determines… more