- Highmark Health (Pittsburgh, PA)
- …Network **Job Description :** The **Allegheny Health Network (AHN)** is recruiting a full -time ** Physician Advisor** to join our team located in **Pittsburgh, ... Physician Advisor is an integral part of the Utilization Management Committee and participates in hospital and enterprise-level...observation services on the bi-weekly Throughput Meeting. + The Physician Advisor needs to be able to review… more
- YesCare Corp (Philadelphia, PA)
- …measures including sentinel event review . + Actively participant of the Utilization Review process and follow proper procedures. + Other duties as ... expertise. **ID** _2024-20068_ **Job Locations** _US-PA-Philadelphia_ **Category** _Physician & Physician Leadership_ **Position Type** _Regular Full -time_ **Shift… more
- Guthrie (Sayre, PA)
- …years of experience in an acute care setting with strong care management, utilization review , and payer knowledge. A Case Management certification or obtaining ... of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria. b) Educates the physician and… more
- Guthrie (Sayre, PA)
- …operational aspects for Care Coordination including, but not limited to Case Management, Utilization Review (UR), Utilization Management (UM), and Medical ... knowledge in and experience of payer contract language, as it relates to utilization management. Can navigate through the requirements imposed by all payers. Prior… more
- Centene Corporation (Harrisburg, PA)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization of… more
- Penn Medicine (Philadelphia, PA)
- …being. Accurate analysis and evaluation of all studies will be provided to interpreting physician for review . Will fulfill responsibility to HUP by adherence to ... or Echo lab manager.Analyzes and evaluates results of studies for review by interpreting physician and or department manager.Monitors testing equipment… more
- Penn Medicine (Lancaster, PA)
- …living your life's work? Job Description **LOCATION** : Lancaster, PA **HOURS** : Full -Time, Day Shift, 40 hours/week. Shifts vary from 8:00am to 4:30pm and 8:30am ... patient/provider office visits, nurse visits, and telephone triage. Collaborates with Physician and Advanced Practice Providers (APPs) to provide patient care and… more
- Guthrie (Sayre, PA)
- …in short/long range facilities planning, construction, major rehabilitation, and space utilization programs. * Experience and successes in communicating and managing ... to reduce cost and improve response time. 14. Oversees the department, review , approval, and implementation of department policies and procedures on safety, risk… 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
- Guthrie (Sayre, PA)
- …knowledge by participation in continuing education, reading journals, resource utilization , vendor resources, and attending any required courses as observed ... the effective day‐to‐day operation of the systems and the review of system reports and responding to user requests...Employer. The Guthrie Clinic is a non-profit, integrated, practicing physician -led organization in the Twin Tiers of New York… more