Utilization Management Specialist jobs in Philadelphia, PA

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Diabetes Business Specialist - Philadelphia, Pennsylvania (N...
Boehringer Ingelheim - 587 reviews - Philadelphia, PA
Diabetes Business Specialist Requirements:. Exective Diabetes Business Specialist Requirements:. Completes all administrative responsibilities as directed by...
Medical Director Behavioral Health
Utilization management experience preferred with a minimum of five years of progressive business experience. Five plus years of medical management and general...
Genetic Counselor--Neuroscience
Nemours - 202 reviews - Wilmington, DE 19801
This position will also participate in a pilot program for utilization management within the laboratory. Efficient case management and medical documentation...

Utilization Management Specialist

NewCourtland Network - 14 reviews - Philadelphia, PA
Under the direction of the AVP of Utilization Management, The UM Specialist implements and supports processes that assist the Network reach and/or maintain...

Special Needs Coordinator

Aetna - 2,441 reviews - Philadelphia, PA
Develops and presents informational reports on the special needs members based on member enrollment, utilization of service(s) and/or case management outcomes....

Clinical STARS-HEDIS Specialist

Health Partner Plans, Inc. - Philadelphia, PA 19107 (City Center East area)
Knowledge of clinical case management, medical terminology preferred. 3-5 years’ experience in managed care, clinical case management or quality review....
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Clinical Documentation Specialist

Thomas Jefferson University and Hospitals - 391 reviews - Philadelphia, PA
Case Management experience helpful. Position available for a full time (80 hours biweekly) Monday-Friday Clinical Documentation Specialist in the Clinical...

Lead Client Services Management Specialist

Verizon - 15,082 reviews - Philadelphia, PA 19103 (Belmont area)
Responsible for Service Relationship Management, Change Management, Financial Management. Program support of Project Management lead....

Government Programs Compliance Specialist (HCM)

Health Partner Plans, Inc. - Philadelphia, PA 19107 (City Center East area)
1-3 years of Utilization Management delegated vendor experience. 3-5 years of utilization review and/or case management experience....
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Clinical Nurse Specialist CCU

University of Pennsylvania Health System - 134 reviews - Philadelphia, PA
A hallmark of CNS practice is the management of complex patient-family situations. Components of patient care, consultation, research utilization and education...

Specialist, CSS Workforce Management Strategy

Johnson & Johnson Family of Companies - 2,279 reviews - West Chester, PA  +1 location
Currently recruiting for a Specialist, CSS Workforce Management Strategy with. Management Specialist is part of a team leading the workforce planning function....

Clinical Documentation Improvement Educator

Einstein Healthcare Network - 79 reviews - Philadelphia, PA 19115 (Bustleton area)
A broad knowledge of the disease process, normal/abnormal findings, and reasonable course of treatment, quality measures, and risk management issues is...

D & A Specialist

WES Health System - 23 reviews - Philadelphia, PA
Serves as the drug and alcohol specialist for the case management unit. WES Health System has an exciting opportunity available in our Blended Enhanced Targeted...
Enterprise Systems Solutions - SAP/Salesforce Manager
PwC - 3,958 reviews - Philadelphia, PA 19113
Boards of Directors and executive management recognize the ever increasing importance of effective risk management efforts in meeting their organization's...
Clinical Specialist II
Melmark - 63 reviews - Berwyn, PA 19312
In addition, the Clinical Specialist II will assist with specific case management responsibilities, including but not limited to, preparation for utilization...

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