- Highmark Health (Pittsburgh, PA)
- …with operational areas regarding issues related to supported technology. Manage utilization review , translation of foreign claims, coordination of benefits ... **Company :** Allegheny Health Network **Job Description :** Date Posted:...benefits/requirements/limits, discharge planning requirements, length of stay and resource utilization issues. + Adheres to the policies, procedures, rules,… more
- UPMC (Pittsburgh, PA)
- …Insurance + Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR) + Driver's License + Registered Nurse ( RN ) + Act 33 with renewal + Act 34 ... Are you an experienced nurse with an extensive background in case management?...Manager will visit members in the community setting in Allegheny County. The HCBS Command Team provides case management… more
- Highmark Health (Natrona Heights, PA)
- …in utilization management and/or employment by a third party payor/ review agency preferred. Highmark Health and its affiliates prohibit discrimination against ... **Company :** Allegheny Health Network **Job Description :** _At AHN,...to the pre-established standards. **ESSENTIAL RESPONSIBILITIES** + Responsible for utilization management. (50%) + Communicates and collaborates with physicians… more
- Highmark Health (Jefferson Hills, PA)
- …including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and ... **Company :** Allegheny Health Network **Job Description :** Jefferson Hospital...engages patients/caregivers in their healthcare, and supports effective resource utilization . Serves as key team members in the management… more
- Commonwealth of Pennsylvania (PA)
- …I have professional experience performing this Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or ... Experience and Training Requirements: + Two years as a Registered Nurse Supervisor or three years as...Work Behavior as a charge nurse , head nurse , utilization review nurse… more