- UPMC (Pittsburgh, PA)
- …and retrospective reviews, member grievances, provider appeals, and potential quality of care concerns. + Provide expedited review and determination of medically ... license. The ideal candidate will have 5-10 years of clinical experience, as well as managed care ...of clinical experience, as well as managed care experience. **Licensure, Certifications, and Clearances:** + Doctor of… more
- Organon & Co. (Plymouth Meeting, PA)
- …are currently recruiting for an Associate Director, Peer-to-Peer Education & Health Care Provider (HCP) Activation for Dermatology (US). The position will be based ... partners. + Demonstrated project management expertise and hands-on MLR review experience. + Requires approximately 20-25% travel, including some...and Skills** + MBA or advanced business degree. + Clinical degrees or licenses such as BSN, NP, PA,… more
- Highmark Health (Natrona Heights, PA)
- …Description :** **GENERAL OVERVIEW:** This job is an integral part of the care delivery system working together to provide a healing environment, by placing our ... **ESSENTIAL RESPONSIBILITIES:** + Perform complete, detailed and accurate histories, review patient records and perform complete physical examinations. (25%) +… more
- Geisinger (Danville, PA)
- …using the rooming tool within the electronic medical record. + Completes medication review . + Accompanies providers and care team members during patient ... work in a progressive learning environment while providing top-notch care in an outpatient clinical setting. Education...while providing top-notch care in an outpatient clinical setting. Education High School Diploma or Equivalent (GED)-… more
- Datavant (Harrisburg, PA)
- …product vision, strategy, and roadmap for the Prospective Suspecting and Concurrent Review solutions within Datavant's Clinical Insights Platform suite. + Define ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...in working with provider documentation teams, coders, or concurrent review vendors. + Clinical experience or deep… more
- Surgery Care Affiliates (Philadelphia, PA)
- Overview At SCA Health, we believe health care is about people - the patients we serve, the physicians we support and the teammates who push us forward. Behind every ... As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for...we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork… more
- Gentiva (Shamokin Dam, PA)
- …be assigned to a location to conduct Face-to-Face (F2F) visits that support the clinical eligibility of patients receiving hospice care . Your focus will be ... **Overview** **Advance compassionate care where it matters most** Are you passionate...performing physical assessments and clinical documentation that supports the hospice physician's certification or… more
- Trinity Health (Springfield, PA)
- …work) and other home health services. Our legacy continues with a pioneering, future-thinking care model. We blend clinical expertise with our exclusive Home ... Full time **Shift:** **Description:** **Human Resource Specialist** **needed for Mercy Home Care ** Mercy Health Home Care provides compassionate, exceptional … more
- Commonwealth of Pennsylvania (PA)
- …+ Benefits + Questions THE POSITION If you possess a robust clinical background, strong leadership skills, and the ability to manage resources efficiently, ... best practices and ensuring the delivery of high-quality patient care at our Southeastern Veterans Center. If you are...WORK In this vital position, you will assist the Clinical Services Manager in the planning, organization, and management… more
- Geisinger (Danville, PA)
- …care activities which may include (but not limited to) sterile product preparation, clinical interactions with patients and the care team, and performance of ... of the pharmacist, performing duties related to patient, provider, and customer care under the supervision of a pharmacist. The intern has responsibility with… more