- Virtua Health (Pennsauken, NJ)
- …necessity tools to maintain compliance and achieve cost effective and positive patient outcomes .Acts as a resource to other team members including UR Tech and AA ... to support UR and revenue cycle process.Position Responsibilities: Utilization Management* Utilizes Payer specific screening tools as a resource to assist in the… more
- AmeriHealth Caritas (Philadelphia, PA)
- …provides organizational leadership in the operational areas of care management, utilization review , appeals, quality improvement and related policy and ... practice initiatives in collaboration with the Corporate Medical Director(s), Utilization Management and the Vice President, Medical Affairs. ;The following… more
- Penn Medicine (Philadelphia, PA)
- …+ Registered Nurse - PA (Required) + 5yrs prior experience as a Nurse Case Manager with knowledge of utilization review and 3rd Party Payors (Required) ... payer reimbursement.Asses clinical information for appropriateness of settling and utilization of resources to optimize patient outcomes ...And 5+ years Prior experience as a nurse case manager with knowledge of utilization review… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …to work and adjust to different environments. Knowledge of Interqual and utilization review standards. Experience in clinical documentation within electronic ... SIGN ON BONUS The role of the ER Care Manager is to increase patient through put to the...Experience in Care Coordination, Discharge Planning, Clinical Documentation and Utilization Review preferred. Strong verbal, written and… 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 ... working remote for the remaining hours. The Acute Care Manager , Complex Care (RN) is responsible for achieving positive...required + A minimum of one (1) year of utilization review and/or case management, home health,… more
- ENFRA (Glenolden, PA)
- …to achieving project outcomes and scope completion with the director, project manager , engineering project executive, and energy manager . + Ensure that all ... of our continued success. **Overview** The IS Technical Services Team Manager is responsible for the execution of Retro-Commissioning and Commissioning services,… more
- Fresenius Medical Center (Swarthmore, PA)
- **PURPOSE AND SCOPE:** Leads regulatory surveys and promotes utilization of continuous quality improvement (CQI) principles, methods, and tools. Directs, ... facility audits. Conducts exit conferences with facility management staff to review survey findings and to make recommendations. Provides guidance to operations… more
- TD Bank (Mount Laurel, NJ)
- …for this role. **Line of Business:** Audit **Job Description:** The Audit Manager is accountable for overseeing the planning and execution for audits covering ... + Performs testing of critical areas of audit. Performs review of audit documentation. Oversees findings follow up and...+ Ensure resources are effectively utilized to achieve target utilization rates + Accountable for promoting recognition in the… more
- Penn Medicine (Philadelphia, PA)
- …critical thinking skills and being a strong patient advocate. The case manager conducts utilization management activities, communication with insurers, team, and ... will miss patient contact? If so, our nurse case manager role at Penn Medicine is the perfect transition...of quality patient care that facilitates discharge and expected outcomes . Our nurse case managers are integral members of… more
- ChenMed (Philadelphia, PA)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... Primary Care Physician (PCP) in our organization demonstrates: * Accountability for outcomes : The PCP demonstrates accountability for outcomes , strong clinical… more
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