- Evolent (Harrisburg, PA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to… more
- Evolent (Harrisburg, PA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... culture. **What You'll Be Doing:** As a Physician Clinical Reviewer , Interventional Pain Management, you will be a key...Management, you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Harrisburg, PA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Director you will be a key member of the utilization management team. We can offer you a meaningful...Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet… more
- Evolent (Harrisburg, PA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Director you will be a key member of the utilization management team. We can offer you a meaningful...Will Be Doing:** + Serve as the specialty match reviewer in Vascular cases, that do not initially meet… more
- Evolent (Harrisburg, PA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Oncology, you will be a key member of the utilization management team. We can offer you a meaningful...Will Be Doing:** . Serve as the Physician match reviewer in Advanced Imaging cases, that do not initially… more
- Evolent (Harrisburg, PA)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Radiology you will be a key member of the utilization management team. We can offer you a meaningful...Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that do not initially meet… more
- Penn Medicine (Philadelphia, PA)
- …the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership. The Physician Advisor ... changes in payer rules including CMS rules as it pertains to utilization review * Recommend and request additional and more complete medical record documentation… more
- Evolent (Harrisburg, PA)
- …focus on **value-based strategy and transformation** . Unlike traditional medical review roles that emphasize volume throughput, this position integrates ... utilization management with collaborative engagement and innovation. **Core Responsibilities**...with collaborative engagement and innovation. **Core Responsibilities** + **Clinical Review & Peer Collaboration** + Serve as the physician… 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
- Terracon (Pittsburgh, PA)
- …operations of a department including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, quality ... or licensure in field of expertise. + Terracon Authorized Project Reviewer status preferred. **Exemption:** Exempt **Requisition ID:** 34261BR **Posting Title:**… more