- Evolent (Harrisburg, PA)
- …mission. Join a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer , Nurse, you will be a key member of the utilization management ... while providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse, you will routinely interact...**What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases,… more
- UPMC (Erie, PA)
- …and the quality of patient care . Makes recommendations for the improvement of clinical care and the health of the workplace and welcomes and participates in ... Join Our Team at Children's Express Care Erie! Are you passionate about pediatrics and...initiative and seeks formal and informal opportunities to improve clinical practice. Seeks guidance and asks questions to continuously… more
- Highmark Health (Harrisburg, PA)
- …is not only safe but expected. + Participates on interdisciplinary team to evaluate clinical care or health services. + Promotes patient safety initiatives (ex: ... clinical teams in one of the three specific clinical teams, including:** + **Critical Care ** +...professional skills and knowledge. + Participates in systematic peer review and obtains informal feedback regarding one's own practice… more
- Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
- …(HCC's) Completes assignments with an emphasis on completeness, accuracy, and supporting clinical care plans to Risk Adjustment Data Validation (RADV) Timelines. ... improvement experience, or other relevant experience preferred. Experience working in health care and insurance Industry. Knowledge base of clinical standards of… more
- WellSpan Health (Mount Gretna, PA)
- …Day shift **General Summary** Performs a variety of duties to facilitate quality clinical care within the Inpatient Child/Adolescent and Adult Psychiatric Units. ... care progression in discharge readiness by rounding with care team, using clinical judgment to identify...with Case Management as indicated. + Participates in the review of policy and procedures on an ongoing basis… more
- Highmark Health (Harrisburg, PA)
- …safe plans for transition and care coordination. (20%) + Coordinates the clinical care with the patient, family, provider(s), and members of the ... interdisciplinary team partners including but not limited to: appropriateness of care , documentation requirements, utilization review principles and criteria,… more
- Guthrie (Sayre, PA)
- …Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for ... a $5,000 sign on bonus Performs duties of a clinical and clerical nature. Maintains records and applies knowledge...and all other patient results to the provider for review and assists with patient communication. + Responsible for… more
- Highmark Health (Wexford, PA)
- …support, and addresses emotional demands of having a chronic condition. Reinforces the clinical care plan and follows up for ongoing activation. (10%) + ... team, assists with population health management through patient outreach and coordination of care , participates in the clinical visit to assist the provider, and… more
- Humana (Harrisburg, PA)
- …this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of ... work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient… more
- Highmark Health (Jefferson Hills, PA)
- …and adaptability are key. + Collaborates with an interdisciplinary team to evaluate clinical care or health services. + Promotes patient safety initiatives (ex: ... Network **Job Description :** 5 South - Medical Progressive Care Jefferson's Medical Progressive Care Unit consists...Provides peers with both verbal and written feedback regarding clinical practice and role performance. + Shares knowledge and… more