Utilization Review Jobs in Pittsburgh
1 - 14 of 14
Search Results - Utilization Review Jobs in Pittsburgh
9025 CVS Shared Services Resources LLCPittsburghappcast.io
management initiatives across the care continuum.
The position focuses on utilization review, quality assurance, and predetermination reviews, including prior authorization, peer reviews, and appeals.
#J-18808-Ljbffr...
MTC CarePittsburgh
practice, and psychopharmacology including writing orders for medications, as appropriate
• Participate in case reviews, consultations and utilization review
• Respond to urgent calls from the facility and facilitate problem-solving
• Stay current...
Dane Street, LLCPittsburghappcast.io
expertise in medical necessity, utilization review, and claims support
• Expanded credentials as an expert medical reviewer
• Fully prepped cases, streamlined workflow, transcription services at no cost, and a user-friendly online portal
If you...
Green Key ResourcesPittsburgh
or Utilization Review experi
enceAbility to attend monthly meetings in Manha
ttan...
Dane Street, LLCPittsburghappcast.io
is provided. These are advisory-only opinions.
• Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
• Expanded credentials as an expert in Independent Medical Exams
• Fully...
Dane Street, LLCPittsburghworkable.com
medical record reviews, utilization review, and evidence-based advisory assessments while maintaining flexibility and working remotely....
Encompass Health Rehabilitation Hospital of MechanicsburgPittsburgh
Ensure accuracy of discharge and payor-related information in the patient record
• Participate in utilization review process: data collection, trend review, and resolution actions.
• Participate in case management on-call schedule as needed...
Equity Staffing GroupPittsburgh
Management and Retrospective Drug Utilization Review program protocols providing clinical recommendations pertaining to, but not limited to, gaps in care, high risk medications, compliance and adherence, drug interactions, therapeutic substitution...
Highmark HealthPittsburghappcast.io
Company : Highmark Inc.
Job Summary
This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases...
Equity Staffing GroupPittsburgh
Management and Retrospective Drug Utilization Review program protocols providing clinical recommendations pertaining to, but not limited to, gaps in care, high risk medications, compliance and adherence, drug interactions, therapeutic substitution...
Ascension Recovery ServicesPittsburgh
professional boundaries and confidentiality standards.
• Participate in quality improvement, utilization review, chart review, incident review, and performance-improvement activities.
• Assist leadership with regulatory surveys, accreditation preparation...
Pittsburghicims.com
approach for each claim. These responsibilities may include utilization review, pharmacy oversight and care coordination.
This position is remote in Pennsylvania or Massachusetts!
Responsibilities:
• Uses clinical/nursing skills to determine whether...
BayOne SolutionsPittsburgh
and tuning methodologies.
• Participate in capacity planning, workload forecasting, and resource utilization reviews.
• Ensure high availability and disaster recovery strategies are performance-optimized and cost-effective.
• Manage multiple concurrent...
9025 CVS Shared Services Resources LLCPittsburghappcast.io
Management staff ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews.
This includes Prior...
Companies now hiring in Pittsburgh:
Utilization Review jobs in Pittsburgh – Similar offers:
Utilization Review jobs – More cities:
Broaden your job search:
Don’t miss out on new job openings!
Create a job alert for: Utilization Review, Pittsburgh
It's free, and you can cancel email updates at any time