- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …preferred. + Experience in a combination of home care management, case management review , utilization review , social service support, insurance reimbursement ... significance. The incumbent utilizes care coordination to address patient and physician concerns; obtains insurance approval for designated therapy and proactive… more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …and/or services based on the needs of the organization; + Participating in utilization review activities including but not limited to development of standards, ... all pertinent licensing requirements and accrediting body standards. The Physician will adhere to evidence-based practice guidelines, professional standards, state… more
- Aveanna Healthcare (Harrisburg, PA)
- …appropriately skilled clinician, and within insurance authorization. - Responsible to manage utilization of direct care team members based on patient needs as well ... and distributes the patient/direct care team member schedule. Performs initial review of schedules for productivity/geographic issues. - Completes daily and weekly… more
- CVS Health (Harrisburg, PA)
- …meal delivery, assists with securing DME, and helps to ensure timely physician follow-up. - Understands Payer/Plan benefits, policies, procedures, and can articulate ... who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current...timelines. - Utilizes weekly and daily reporting to identify utilization for the purpose of reducing Emergency Department … more
- KidsPeace Childrens Hospital (Schnecksville, PA)
- …telepsychiatry services based on the needs of the organization; d. Participating in utilization review activities including but not limited to development of ... and Statistical Manual of Mental Disorders, written treatment orders, admissions on-call review for all legal commitment status documents and review and… more
- Prime Therapeutics (Harrisburg, PA)
- …clinical experience. + Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + At minimum must ... Under supervision, is responsible for performing referral services to support independent physician offices with maintaining member drug infusions in office or to… more
- Fresenius Medical Center (Philadelphia, PA)
- …staff in problem solving. **PHYSICIANS:** + Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. + Responsible ... for strong Director and physician relationships and facilitating staff relationships with physicians. +...+ Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic,… more
- UPMC (Camp Hill, PA)
- …and resources. + Serve as liaison for renovations, construction and building utilization with UPMC and outside construction services. + Develop strategic plans for ... contract negotiations and staffing as required. + Assist in physician relations as necessary. + Maintain knowledge initiatives as...in the recruitment of staff and new practices. + Review and evaluate the effectiveness of current procedures and… more
- Penn Medicine (Lancaster, PA)
- …patient/provider office visits, nurse visits, and telephone triage. Collaborates with Physician and Advanced Practice Providers (APPs) to provide patient care and ... to the patient's health or the situation, and concisely relays medical information to physician or APP. + Analyzes the assessment data to determine the diagnosis or… more
- Pfizer (Harrisburg, PA)
- …Sales responsibilities include relationship development with aligned and affiliated physician targets, KOLs, pharmacists, transition of care advocates, quality ... of strong leadership, cross functional leadership, collaboration, and effective utilization of available resources to drive performance. * Strong organizational… more