- UPMC (Pittsburgh, PA)
- …+ Assist clinical team with scheduling transportation, scheduling appointments, and tracking utilization . + Refer members to appropriate case management, health ... The Care Manager Associate (CMA) position will be part of...CMA's collaborations, practical comprehension and hands-on experience in clinical care/ utilization management will result by collecting and assisting with… more
- Geisinger (Wilkes-Barre, PA)
- …Social Workers, Case Workers and Care Management Assistants. This Operations Manager role will have responsibility at our Wyoming Valley and South Wilkes-Barre ... As one of the Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for improving health. Today, we're… more
- Select Medical (Hummelstown, PA)
- …or a closely related field required. **Preferred Experience** + Experience in Utilization Review preferred + Experience in Management preferred + Experience ... stay in collaboration with the clinical team. Conducts ongoing review of the CMS data submitted and the patient's...in ICD-10 coding preferred + Experience as a Case Manager in rehabilitation preferred **Additional Data**… more
- Penn Medicine (Bala Cynwyd, PA)
- …employees shape our future each day. Are you living your life's work? **This manager will be overseeing our** **South / Southwest / West Philly and Delco teams!** ... **Summary:** + The Penn Medicine Hospice Team Manager is responsible for the financial and administrative operations of the hospice nursing team for Penn Medicine… more
- WellSpan Health (York, PA)
- …clinical needs to support optimal health and reduce avoidable healthcare utilization . **General Summary** Coordinates and monitors the health needs of patients ... monitor individualized care plans in partnership with families, pediatricians, specialists, case management, social work, and community partners. + Identify barriers… more
- Sysco (Pittsburgh, PA)
- **JOB SUMMARY** The District Sales Manager (DSM) role requires exceptional management of sale performance among Sales Consultants (SCs). This position is responsible ... developing the talent of their sales consultants to achieve profitable planned case and GP growth **RESPONSIBILITIES** + Manages the performance and development of… more
- Penn Medicine (Philadelphia, PA)
- …advancing their critical thinking skills and being a strong patient advocate.The case manager conducts utilization management activities, communication with ... fearful you will miss patient contact?If so, our nurse case manager role at Penn Medicine is...Accounts for all patient days accurately in Canopy Enters review indicating "pending" status of case if… more
- Evolent (Harrisburg, PA)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical...and findings with matrixed Physician Business Manager . + Provides medical direction to… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans… more
- UPMC (Pittsburgh, PA)
- …role requires three years of coding experience. In this role, you will review clinical documentation within the medical record to ensure that all patient resource ... utilization , principal diagnosis, secondary diagnoses, and PCS procedures have...coding guidelines, third-party payer and OIG regulations. **Responsibilities:** + Review and evaluate focused UPMC DRG medical records for… more