- AmeriHealth Caritas (Newark, DE)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... in a fast-paced environment. ;The Clinical Care Reviewer - Utilization Management will also be counted upon...document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria,… more
- WellSpan Health (Christiana, PA)
- …in the management of patient care between visits. + Assists in the management of patient utilization of health care system and provides patient education ... and patient has been notified. Provides related education, counseling, ongoing review , and monitoring regarding diagnostic tests (ie, INR results in Anticoagulation… more
- Fresenius Medical Center (Wilmington, DE)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Insight Global (Elkton, MD)
- …IP phones. Support and provide technical guidance to the Field Staff. Support of the Nurse Call backend systems. This is an ONSITE position based in Elkton, MD. This ... request. 2. Analyzes system traffic reports as requested by management , including operator statistics, voice mail, ACD, trunk, and...which includes a monthly report on traffic and effective utilization . 9. Oversees the weekly work efforts of the… more