- WellSpan Health (York, PA)
- … needs, use of community resources and responsibilities of membership in managed care . + Completes necessary paperwork, prior authorizations and/or scheduling ... **General Summary** Performs screening to determine appropriate avenue for care of patients. Functions as a member of the...the impact of medical errors and methodology that will lead to the reduction of errors through the reporting… more
- Ascension Health (Milwaukee, WI)
- …nursing facilities including the Alexian Village, ambulatory care facilities, home health care , physician practices, managed care services, and 4 cancer ... residents in the clinic setting to provide high-quality patient care and education. This is a unique opportunity to...ambulatory, hospitalist, and GME programs. + Help develop and lead the ambulatory clinical training program for the Internal… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and working knowledge of Utilization Management Standards. + Experience in interpreting managed care benefit plans and strong knowledge of government program ... various levels of care and/or services. + Participate in committees and lead when required Level III (in addition to Level II Accountabilities) + Displays… more
- WellSpan Health (Gettysburg, PA)
- … needs, use of community resources and responsibilities of membership in managed care . + Completes necessary paperwork, prior authorizations and/or scheduling ... **General Summary** Performs screening to determine appropriate avenue for care of patients. Functions as a member of the...the impact of medical errors and methodology that will lead to the reduction of errors through the reporting… more
- WellSpan Health (Waynesboro, PA)
- … needs, use of community resources and responsibilities of membership in managed care . + Completes necessary paperwork, prior authorizations and/or scheduling ... **General Summary** Performs screening to determine appropriate avenue for care of patients. Functions as a member of the...the impact of medical errors and methodology that will lead to the reduction of errors through the reporting… more
- Trinity Health (Springfield, PA)
- …preferred + Working knowledge of governmental reimbursement criteria, knowledge of third party/ managed care contracts related to Trinity Health At Home services ... the Position:** The RSS role will support the Home Care Coordinator (hospital- based liaison) with referral entry and...and perceiving our world and that these differences often lead to innovative solutions. Our dedication to diversity includes… more
- WellSpan Health (Lewisburg, PA)
- … needs, use of community resources and responsibilities of membership in managed care . + Completes necessary paperwork, prior authorizations and/or scheduling ... **General Summary** Performs screening to determine appropriate avenue for care of patients. Functions as a member of the...the impact of medical errors and methodology that will lead to the reduction of errors through the reporting… more
- ChenMed (Margate, FL)
- …knowledge and skills: + Excellent clinical skills. + Knowledge and experience in a managed care delivery system. + Knowledge of clinical outcomes and quality ... within assigned center. + Partners with center manager to co- lead center stand-ups and deliver exceptional patient care...co- lead center stand-ups and deliver exceptional patient care across their respective teams. + Participates in center… more
- WellSpan Health (Ephrata, PA)
- …using computerized inquiry functions. + Maintains a knowledge base of insurance/ managed care processes related to pre-certifications and authorizations and ... safety observation recommendations in the ED. + Determines appropriate level of care based on the client's history, psychosocial history, clinical presentation, and… more
- CommonSpirit Health (Phoenix, AZ)
- …for a health system, required. + Minimum 5 years of experience performing government, managed care , and commercial appeals required. + Minimum 7 years of ... care . **Essential Key Responsibilities:** + Leadership & Strategy: Lead the System-level Utilization Management (UM) department, ensuring alignment with… more