- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us...in an acute care setting + Previous experience in utilization management/ utilization review for a ... put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to...communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Guthrie (Towanda, PA)
- …and autonomy in nursing practice. Preferred experience with PCMH process, care management/ utilization review , and payer knowledge. Fast paced ambulatory care ... Sign On Bonus For Qualified RNs! Position Summary: Care Coordinator in Primary Care will serve as a practice...Home development and process. The position is an integral part of the Patient Centered Medical Home Team. The… more
- FirstEnergy (Latrobe, PA)
- …Co., a subsidiary of FirstEnergy Corp. [FEU]. The Construction Site Coordinator (CSC) has responsibility to coordinate and supervise pre-construction, construction, ... + Fostering a high-performing safety culture through personal conduct and utilization of human performance principles. + Coordinating and supervising smaller to… more
- Guthrie (Sayre, PA)
- …program development include assisting with feasibility, site selection, IRB document review , and corresponding with investigators, IRB, and sponsors. + Coordinate ... sponsor via the appropriate sponsor case report form submission process after review for accuracy and validation of information is obtained. Maintain study… more
- Humana (Harrisburg, PA)
- …service or customer service telephone experience desired. + Experience with LTSS Utilization Review and/or Prior Authorization, preferably within a managed care ... **Become a part of our caring community and help us...and help us put health first** The UM Administration Coordinator 2 provides non-clinical support for the policies and… more
- Fresenius Medical Center (Philadelphia, PA)
- This can be either a Per Diem or Part -Time Position. We work only day-shift. No Call. No evening shift. No night shift. No holidays. **PURPOSE AND SCOPE:** As a ... Medical Receptionist/Patient Services Coordinator , you will coordinate procedure scheduling, conduct pre-procedure communications with patients, complete data entry… more
- FirstEnergy (Latrobe, PA)
- …Co., a subsidiary of FirstEnergy Corp. [FEU]. The Construction Site Coordinator (CSC) has responsibility to coordinate and supervise pre-construction, construction, ... + Fostering a high-performing safety culture through personal conduct and utilization of human performance principles. + Coordinating and supervising smaller to… more
- Penn Medicine (Philadelphia, PA)
- …and being a strong patient advocate. The case manager conducts utilization management activities, communication with insurers, team, and physician advisor. Discharge ... risk management referrals. Case management allows you to work autonomously while still being part of a high performing team. We also offer flexible schedules and our… more
- Highmark Health (Wexford, PA)
- …with all regulatory agency requirements **ESSENTIAL RESPONSIBILITIES** + Reviews pharmacy utilization management (UM) coverage requests and prepares such cases for ... clinical review by a pharmacist and/or medical director when required....years of experience as a Pharmacy Technician, Patient Access Coordinator , or Medical Assistant in health care setting **Preferred**… more
- Erickson Living (Warminster, PA)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... indicators/benchmarking such as Falls, Pressure Ulcers, Medication Errors, Restraint Utilization , Re-hospitalization, Anti-psychotic utilization , ADL splits/documentation, etc.… more