- WellSpan Health (Lebanon, PA)
- …with leadership, healthcare providers, and hospital staff to analyze and improve clinical care practices. In accordance with applicable regulatory and ... throughout WellSpan footprint 2 days Remote **General Summary** Promotes an environment of safe care for patients by supporting patient safety initiatives. Works… more
- UPMC (Pittsburgh, PA)
- …this role requires three years of coding experience. In this role, you will review clinical documentation within the medical record to ensure that all patient ... and procedures that were performed during an episode of care . + Review billing data when conducting...support the additional diagnosis. + Three years of previous clinical acute care medical/surgical experience to include… more
- UPMC (Pittsburgh, PA)
- …delays in discharge. + Documents all Avoidable Days in CANOPY system. + Performs clinical review on admission and/or continued stay using InterQual criteria to ... fulfilled this mission since its founding in 1890.** The Care Manager (CM) coordinates the clinical and...1890.** The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs overall utilization… more
- Centene Corporation (Harrisburg, PA)
- …in the week. Eligible for 4-10HR shifts, or 5-8HR shifts. **Position Purpose:** Performs a clinical review and assesses care related to mental health and ... state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review and/or...preferred. Experience working with providers and healthcare teams to review care services related to mental health… more
- UPMC (Pittsburgh, PA)
- The Regional Medical Director, CC/DP and Utilization Review , provides clinical and management leadership across multiple hospitals within the region. This role ... appropriateness, LOS, and reduce denials. + Direct UM functions, collaborating with CC/DP, clinical teams, and attending physicians to optimize care delivery and… more
- St. Luke's University Health Network (Easton, PA)
- …Counselor (LPC). TRAINING AND EXPERIENCE: At least 2 to 5 years of clinical experience providing care to patients with mental health illness. Previous ... which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses...the age of the patient treated. + Performs admission review on all inpatients. Attends daily patient rounds and… more
- St. Luke's University Health Network (Sellersville, PA)
- …Demonstrates Performance Improvement in the following areas as appropriate: Clinical Care /Outcomes, Customer/Service Improvement, Operational System/Process, and ... which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses...+ Other related duties as assigned, eg peer record review PHYSICAL AND SENSORY REQUIREMENTS: Must be able to… more
- Sumitomo Pharma (Philadelphia, PA)
- …organization. + Perform other duties as assigned. **Key Core Competencies** + Patient care clinical experience or strong scientific research experience in the ... projects. + Accumulate key competitive information to aid the clinical and marketing teams in drug/brand development. + Identify,...and technical expertise in the area of oncology through review of the scientific literature and attendance at key… more
- Redeemer Health Home Care & Hospice (Meadowbrook, PA)
- …records required. Experience in Care Coordination, Discharge Planning, Clinical Documentation and Utilization Review preferred. Strong verbal, written ... services, or senior care communities, you are recognized as a valued clinical expert. Serving southeastern Pennsylvania and New Jersey, we are home to a diverse,… more
- Evolent (Harrisburg, PA)
- …(FDA), and various prior authorization lists, facilitating timely decision-making for clinical and business review teams. + Demonstrate strong analytical ... in value-based healthcare analytics or utilization management within a payer, provider, clinical vendor, managed care , or healthcare consulting environment. +… more