- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data ... DUTIES AND RESPONSIBILITIES: + Conduct retrospective medical record reviews for clinical validation of diagnosis and procedure code assignment and MS-DRG/APR-DRG… more
- UPMC (Bridgeville, PA)
- UPMC Rx Partners is looking for a full time Pharmacy Clinical Review Specialist to join their dedicated team! This position provides prescription data entry and ... provides customer service to Rx Partners Skilled nursing and Hospice clients. The clinical review specialist at Rx Partners works hand in hand with a licensed… more
- Penn Medicine (Philadelphia, PA)
- …ongoing education and training on current trends in documentation and coding + Enter clinical review data and related anticipated follow-up in EPIC PENN Chart to ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- CVS Health (Pittsburgh, PA)
- …Affairs clinical programs and regulatory strategies. + Provide oversight and clinical review of projects ensuring consistency with best practices and ethical ... requests of Medical Affairs UM Policies and Procedures. + Support Clinical Program Review Committee meetings. + Perform as Medical Affairs Ambassador across… more
- Fresenius Medical Center (Dallas, PA)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Evolent (Harrisburg, PA)
- …Will work with the Director of UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory of the United ... responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices of… more
- YAI (Kulpmont, PA)
- …home are being addressed. + The QBMP will attend and participate in the weekly/monthly clinical review . The QMP is responsible to contribute to the agenda and ... situations, and activities. + The QBMP will complete annual clinical Performance Evaluations. + The QBMP will meet regularly...training as necessary. + The QBMP will assume the clinical responsibilities of the Lead RBT in their absence.… more
- YAI (Kulpmont, PA)
- …per BACB guidelines. + Contributes to the agenda of and participates in weekly clinical review meetings and assists with trainings when necessary. + Attends ... + Assists the Qualified Behavior Modification Professional (QBMP) in oversight of clinical functions of a Community Crisis Home (CCH) and/or Enhanced Behavior… more
- Pfizer (Collegeville, PA)
- …results + Support execution for all FIH programs through proof-of concept + Set the clinical data review strategy, ensure quality data and conduct review of ... emerging clinical data and trends; review and query data; present and discusse relevant data...and other internal and external stakeholders + Conduct data review , analysis and interpretation of clinical trials… more
- Edwards Lifesciences (Allentown, PA)
- …search strategies, manage associated documentation, and prepare literature summaries). + Independently review raw and summary clinical data for accuracy; resolve ... experience with maintaining current, in-depth product knowledge including current developments, clinical literature review , as well as therapeutic and product… more