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Part Time Insurance Utilization Review Jobs in Pennsylvania

Encompass Health Corporation

Case Manager

Altoona, PA · On-site

$19.75 - $25.25/hr

Case Manager Career Opportunity (part-time) Recognized for your abilities as a Case Manager Are you ... Participate in utilization review process: data collection, trend review, and resolution actions.

Encompass Health Corporation

Case Manager

Glen Mills, PA · On-site

$19.50 - $25.25/hr

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.

Encompass Health Corporation

Case Manager

York, PA · On-site

$19.75 - $25.25/hr

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.

Encompass Health Corporation

Case Manager

Danville, PA · On-site

$23 - $29.50/hr

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.

Encompass Health Corporation

Case Manager

Reading, PA · On-site

$19.25 - $24.75/hr

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.

Encompass Health

Case Manager

York, PA

$19.75 - $25.25/hr

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.

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All JobsInsurance Utilization Review JobsPart Time Insurance Utilization Review JobsPart Time Insurance Utilization Review Jobs in Pennsylvania

Part Time Insurance Utilization Review information

What is the difference between Part Time Insurance Utilization Review vs Part Time Claims Reviewer?

AspectPart Time Insurance Utilization ReviewPart Time Claims Reviewer
CredentialsTypically requires insurance or healthcare-related certificationsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare settings, insurance companies, or third-party administratorsInsurance companies, claims processing centers, or third-party administrators
Job FocusEvaluating medical necessity and appropriateness of servicesReviewing and processing insurance claims for accuracy and coverage

Part Time Insurance Utilization Review and Part Time Claims Reviewer roles both involve insurance industry work, but focus on different aspects. Utilization review centers on assessing medical necessity, while claims reviewers handle processing and verifying claims. Understanding these differences helps job seekers find the right fit based on their skills and interests.

What cities in Pennsylvania are hiring for Part Time Insurance Utilization Review jobs?

Cities in Pennsylvania with the most Part Time Insurance Utilization Review job openings:

Part Time Insurance Utilization Review jobs near you

Clinical Pharmacist (Part-Time, Days/Evenings)

Pennsylvania Medicine

Lancaster, PA • On-site

$115K - $137K/yr

Part-time

Re-posted 10 days ago

Key responsibilities

  • Evaluate drug therapy in collaboration with physicians and other health professionals to achieve specific patient outcomes.

  • Conduct drug utilization reviews and interpret medication orders to ensure safe and effective medication use.

  • Provide drug information and education to healthcare professionals and patients, and support interdepartmental projects related to medication management.

Penn Medicine rating

7.5

Company rating: 7.5 out of 10

Based on 353 frontline employees who took The Breakroom Quiz

231st of 898 rated healthcare providers

Job description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.
Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Schedule: Days - Mon-Fri 7 am - 3:30 pm + some evenings (11am - 7pm or 12:30-9) works every third weekend /holiday
Sign on Bonus of up to $10,000!!!
Summary:
  • In collaboration with the physician and other allied health professionals, evaluate drug therapy based on acuity potential for problems, and provide medication-related care for the purpose of achieving definite outcomes that impact length of stay, patient satisfaction, satisfaction of other health professionals, and cost containment.
  • Qualified individuals must have the ability with or without reasonable accommodation to perform the following duties:
  • Identifies drug therapy strategies that improve patient outcomes and reduce costs.
  • Utilizes assessment skills in the management of medically complex elderly to monitor responses to drug therapy.
  • Provides information to patients, either directly as a consultation or in preparation of patient teaching aides or computer-generated warning or supplemental information.
  • Conducts drug utilization reviews to assure the quality of drug use. Determines if criteria for drug use are met in patient cases being reviewed.
  • Educates health care professionals and patients in the safe and effective use of medication. This education may be informal e.g. patient care rounds, as a staff development education program, or as part of the hospital's interdisciplinary education program.
  • Support and assist interdepartmental projects as requested e.g. MUE, PandT monographs, newsletter articles, performance improvement activities, etc. .
  • Provides drug information to prescribers and other health care professionals. Contributes articles to the hospital and or pharmacy newsletters. Assures that pertinent drug information is maintained in the pharmacy.
  • Develops criteria and makes recommendations to the Pharmacy and Therapeutics Committee on the appropriate use of medications and or inclusion in the hospital formulary.
  • Interprets and evaluates all medication orders and assures for safe and effective medication, dose route and scheduled administration with clarification as deemed necessary.
  • Reviews physician orders and suggests alternate therapies as appropriate. Demonstrates this activity by preparing clinical intervention documentation.
  • Prepares and dispenses medications in accordance with professional practice guidelines, state pharmacy laws, and regulatory standards in addition to departmental policies and procedures.
  • Advises the physician, nurse and patient regarding the contents, therapeutic action, utilization and possible adverse reactions or interactions of medication.
  • Responds to drug information and poison information requests as required.
  • Performs computer order entry functions and rotates to all work areas as assigned.
  • Actively participates in medication safety programs. Active participation is defined as identifying opportunities to improve safety reporting errors and adverse drug events , and implementing system-based changes as a result of those opportunities.
  • Monitors prescriptions to prevent adverse reactions, allergies and or drug interactions. Counsels physicians, patients and nurses accordingly. Participates in drug interaction notification.
  • Serves as a role model of customer service by responding constructively to the needs of hospital staff. Responding constructively is defined as using a respectful communication style that is consistent with professional collaboration.
Minimum Required Qualifications:
  • Pharm.D. or B.S. Pharmacy with equivalent relevant experience required.
  • Current licensure or eligible to reciprocate in the State of Pennsylvania required.
  • ASHP-Accredited Pharmacy Practice Residency or equivalent experience preferred.
  • A health care provider in good standing with Medicare, Medicaid, and other federal and state health insurance programs, i.e. not excluded from participation in Medicare, Medicaid or any other federal or state health insurance program.
  • Equivalent of three 3 years' experience as a hospital pharmacist.
Credentials:
  • Pharmacist (Required)
  • Previous hospital experience (preferred but not required)
Education or Equivalent Experience:
  • Bachelor of Arts or Science (Required)
We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.
Live Your Life's Work
We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

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