- Evolent (Harrisburg, PA)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- ChenMed (Philadelphia, PA)
- …explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... CRITERIA: + ARNP or similar advanced degree in Nursing required + Current Nurse Practitioner Certification in the State of practice required + Board certification by… more
- Geisinger (Danville, PA)
- …nursing leadership team + Assist professional development coordinator with Ambulatory Nurse Leader program + Assist with ambulatory clinical skill mix assessments ... teams assistance with nursing skill mix optimization. + Assist in review of ambulatory nursing position justifications to ensure appropriate scope assignment.… more
- WellSpan Health (Lebanon, PA)
- …and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation ... of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education relative to health care… more
- WellSpan Health (Gettysburg, PA)
- …and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation ... of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education relative to health care… more
- Fresenius Medical Center (Baden, PA)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
- Prime Healthcare (Bristol, PA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... institution in a Health and Human Services field is highly preferred. 2. Utilization Review /Case Management experience is highly preferred. 3. 1+ year of… more
- Penn Medicine (Philadelphia, PA)
- …+ 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) + Pennsylvania State Licensed Nurse ... years Prior experience as a nurse case manager with knowledge of utilization review and third-party payors. We believe that the best care for our patients… more
- ChenMed (Philadelphia, PA)
- …assess and record patients' progress and adjust and plan accordingly + Understanding utilization review and how to leverage with inpatient staff for possible ... through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care...required + A minimum of one (1) year of utilization review and/or case management, home health,… more
- Penn Medicine (Philadelphia, PA)
- …the 12 hour shifts but are fearful you will miss patient contact? If so, our nurse case manager role at Penn Medicine is the perfect transition career for you, and ... will bring you joy and fulfillment. The HUP Nurse Case Manager position creates an exciting opportunity for experienced nurses to expand their knowledge and apply it… more