- Evolent (Harrisburg, PA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a...MD review process to reflect appropriate utilization and compliance with… more
- Penn Medicine (Philadelphia, PA)
- …records for accuracy and to filter out duplicates prior to routing for clinical review . Utilizing scanners and scanning software, uploads all pertinent documents ... for accuracy and to filter out duplicates prior to routing for clinical review . Utilizing scanners and scanning software, uploads all pertinent documents into… more
- CVS Health (Harrisburg, PA)
- …reporting to align local efforts with state and national quality goals. **Key Responsibilities** ** Clinical Review & Compliance** + Review and evaluate ... combines clinical expertise with quality improvement leadership, including clinical documentation review , Performance Improvement Projects (PIPs), ANE… more
- Evolent (Harrisburg, PA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be a...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Harrisburg, PA)
- …utilization management with collaborative engagement and innovation. **Core Responsibilities** + ** Clinical Review & Peer Collaboration** + Serve as the ... play a pivotal role in advancing value-based care models that prioritize clinical excellence, patient-centered outcomes, and system-wide impact. This role offers the… more
- UPMC (Pittsburgh, PA)
- …obtained to support authorization, level of care and/or medical appropriateness. + Ensure clinical review process is followed in order to meet payor deadlines. ... current knowledge of regulatory guidelines related to authorizations. + Perform clinical review for cases referred for cases requiring authorization or adherence… more
- Evolent (Harrisburg, PA)
- …provides clinical rationale for standard and expedited appeals. . Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance... review process to reflect appropriate utilization and compliance with… more
- Evolent (Harrisburg, PA)
- …provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance... review process to reflect appropriate utilization and compliance with… more
- CVS Health (Harrisburg, PA)
- …and optimal, cost-effective outcomes. Assessment of Members: Through the use of clinical tools and information/data review , conducts comprehensive assessments of ... standard business hours. No weekends and no holidays.** Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical… more
- University of Pennsylvania (Philadelphia, PA)
- …and storage of biological samples and related study documents, and collection of clinical data. Assist with Institutional Review Board (IRB) filings and ... programs and resources, and much more. Posted Job Title Clinical Research Coordinator A/B Job Profile Title Clinical...as assigned CRC-A + Prepare and process all Institutional Review Board (IRB)through the IRB and other regulatory groups… more