- 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
- Fresenius Medical Center (Upper Darby, PA)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… 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
- Penn Medicine (Radnor, PA)
- …accurate timecard review and approval, reviews and manages all overtime utilization . + Assists with the implementation of change management strategies within ... life's work? **Job Title:** Associate Clinical Manager Licensed Practical Nurse **Department:** MSKR and Neuroscience Shared Services **Location:** Penn Medicine… 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