- AmeriHealth Caritas (Newtown Square, PA)
- …Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership ... policy and practice initiatives in collaboration with the Corporate Medical Director (s), Utilization Management and the Vice President, Medical Affairs. ;The… more
- Wellpath (Lemoyne, PA)
- …education, and point of care support. **How you make a difference** The Medical Director of Utilization Management leads and oversees utilization ... quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with… more
- The Cigna Group (Philadelphia, PA)
- **Overall** Responsible for leading clinical strategy development and product management for pharmacy utilization management and the coordination of rebate ... contracting efforts to ensure alignment across formulary, utilization management , SafeGuard, and other trend solutions. **Essential Functions:** + Ability to… more
- Humana (Harrisburg, PA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Harrisburg, PA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Harrisburg, PA)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- YesCare Corp (Philadelphia, PA)
- …with the Regional Medical Director provide psychiatric leadership for the utilization management program in the region. Provide timely feedback in ... is a list of your responsibilities as a **Psychiatric Director ** with YesCare with the Philadelphia Contract. + Provide...Utilization Management matters including outpatient and inpatient… more
- WellSpan Health (York, PA)
- Utilization Management Nurse (RN) - Case...for which criteria are not met to the Medical Director . + Demonstrates a working knowledge of managed care ... effective and quality health care. Provides leadership in the integration of utilization management principles throughout the System. Responsible for screening… more
- Evolent (Harrisburg, PA)
- …LMSWs, LCSW, and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be ... Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing… more
- UPMC (Hanover, PA)
- …(CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and ... hiring a part time Professional Care Manager for our Utilization Review department in Hanover! This is a part...leadership role in concurrent denial process. Works with Care Management Director , Physician Advisor, Attending Physicians and… more
- Evolent (Harrisburg, PA)
- …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... + On a requested basis, may function as Medical Director for selecting health plans or regions, assuming overall...selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with… more
- GoTo (Harrisburg, PA)
- …of opportunities for growth and learning, blaze your own trail with us. As the Senior Director or Director of Product Management for our ITSG Team, you will ... be at the forefront of our IT management product strategy, overseeing the development and execution of...business growth. **Your Day to Day** **As the** **_Senior Director or Director of Product Management_** **,… more
- Genesis Healthcare (Pennsburg, PA)
- …or In-Training (IT) Director of Rehab is responsible for assisting the Director of Rehab in the efficient management of rehabilitation services in his/her ... of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- Genesis Healthcare (Norristown, PA)
- …Area Director ). 11. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... management of the rehab department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
- Evolent (Harrisburg, PA)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Evolent (Harrisburg, PA)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a… more
- Bayer (PA)
- …teams monitor trends and utilization of patient support services and utilization management (ie: prior authorization submissions & approvals); + Partner with ... diverse minds to make a real difference, there's only one choice.** **Senior Director of Pull-Through Strategy** The Senior Director of Pull-Through Strategy is… more
- ARAMARK (Philadelphia, PA)
- **Job Description** **Talent Acquisition Director - Facilities Management ** The **Talent Acquisition Director ** will lead a team of recruiters, delivering ... strategies to address high-volume hourly openings inclusive of hiring events, utilization of artificial intelligence and evaluation of new tools **Recruitment**… more
- Grant Thornton (Philadelphia, PA)
- As a Health Care Transaction Management Director , you'll focus on buy-side and sell-side transaction engagements, serving dynamic organizations with experienced ... role) + Provide expertise in the following: + Deal Management Office support + Clear understanding of client's deal...professional development + Meeting or exceeding targeted billing hours ( utilization ) + Other duties as assigned You have the… more
- Colliers Engineering & Design (Philadelphia, PA)
- …+ Relationship management internally and externally for the team. + Management of work assignments to achieve utilization goals. Financial Management ... You'll be at the helm, driving success across every aspect of business management in your region. From developing to leading and inspiring a high-performing team… more