- Highmark Health (Pittsburgh, PA)
- …drug utilization reports, and write drug monographs for Committee review to develop the Organization's Drug formulary and/OR provide recommendations for NDC ... and stakeholders across the organization. Key responsibilities will include clinical review , assisting in navigating a complex regulatory environment, working with… more
- BriteLife Recovery (Hanover, PA)
- …functions. + Under direction of supervisor, establish appropriate therapeutic boundaries, utilization of identified clinical resources to review boundaries, ... limit setting for behavior, and develop therapeutic relations with clients. + Assists in monitoring the therapeutic activities with patients., assist other team members as needed. + Work directly with the clients and provide proper recovery support. What we… more
- BriteLife Recovery (Hanover, PA)
- …or needs. + Under direction of supervisor, establish appropriate therapeutic boundaries, utilization of identified clinical resources to review boundaries, limit ... setting for behavior, and develop therapeutic relations with clients. + Assists in monitoring the therapeutic activities with patients, assist other team members as needed. + Work directly with the clients and provide proper recovery support. + Special… more
- Veterans Affairs, Veterans Health Administration (Philadelphia, PA)
- …on current administrative guidelines. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic ... schedules are closely monitored to effectively support the needs of the clinics, and makes adjustments as necessary. Develop and/or maintain effective and efficient communication with the patient, interdisciplinary coordinated care delivery model teams, VA… more
- BriteLife Recovery (Hanover, PA)
- …+ Under the direction of supervisor, establish appropriate therapeutic boundaries, utilization of identified clinical resources to review boundaries, limit ... setting for behavior, and develop therapeutic relations with clients. + Assist in monitoring the therapeutic activities with patients, assist other team members as needed. + Work directly with the clients and provide proper recovery support. What we need from… more
- UPMC (Media, PA)
- …Care members. This includes significant responsibility for quality management and utilization management and for assuring the adequacy of the provider network ... to Community Care members. + Focus on quality and utilization from a regional perspective to include UPMC Passavant...+ Advises the Regional Director on the development and review of programs, positions, and budgets having an impact… more
- UPMC (Pittsburgh, PA)
- …face-to-face assessments that include a clinical assessment and treatment, a review of the medical, functional, behavioral, pharmaceutical, and social needs of ... the member, including instrumental activities of daily living. Review UPMC Health Plan data and EMR data, and documentation in the member's electronic health records… more
- UPMC (Pittsburgh, PA)
- …promotes healthy lifestyles, closes gaps in care, and reduces unnecessary ER utilization and hospital readmissions. Coordinate and modify the care plan with member, ... and other health plan and system departments as appropriate. + Review member's current medication profile; identify issues related to medication adherence,… more
- WM (Philadelphia, PA)
- …responsible for delivering industry leading maintenance performance and asset utilization . Responsible for delivering excellence in cost, equipment availability, ... asset utilization , shop productivity management and performance improvements and fleet...to encourage safe and efficient operations. Meet all financial review dates and corporate directed programs in a timely… more
- Healthfirst (PA)
- The Case Manager, Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge planning, ... and case management as assigned. The Case Manager, Utilization Management is also responsible for efficient utilization of health services and optimal health… more