- Hunterdon Health Care System (Flemington, NJ)
- Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the effective and efficient ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- PPL Corporation (Allentown, PA)
- …and decision-making process. This position performs complex tasks such as review of reporting materials, presentation of reporting materials, data updates from ... forecast changes, review or preparation of month end manual accruals and...line of business leaders, develop the plan for full utilization of labor resources, identification of support function labor… more
- St. Luke's University Health Network (Sellersville, PA)
- …mental health/crisis intervention experience required. Previous experience with case management/ utilization review and managed care models preferred. Please ... may require treatment with seclusion/restraints. + Supports the function of utilization management regarding pre-certification process for all intakes and consults.… more