• Director, Quality and Risk

    St. Luke's University Health Network (Orwigsburg, PA)
    …The Director, Quality and Patient Safety is responsible for all aspects of Quality, Clinical Risk Management and Patient Safety for their assigned entity. ... Patient Safety Hotline. + Analyzes actual and potential adverse clinical events at assigned entity for risk ...in Healthcare Quality (CPHQ) or Certified Professional in Healthcare Risk Management (CPHRM) or appropriate alternative within… more
    St. Luke's University Health Network (08/08/25)
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  • Assistant Patient Care Manager, Surgical Services

    St. Luke's University Health Network (Sellersville, PA)
    …staff competency, and initiates remedial actions, when appropriate + Acts as liaison with Clinical Risk Management and participates in event reviews, action ... standards for professional nursing practice. JOB DUTIES AND RESPONSIBILITIES: + Demonstrates clinical expertise and serves as clinical resource to staff +… more
    St. Luke's University Health Network (08/29/25)
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  • HCare Compliance Invest 2

    Public Consulting Group (Harrisburg, PA)
    …experience in Medicaid billing, Medicaid programs, incident investigation, quality assurance, and/or clinical risk management **Working Conditions** + Office ... desk and routine reviews of assigned providers to determine compliance with clinical policies, licensing rules, state and federal regulations. + Conduct thorough… more
    Public Consulting Group (09/06/25)
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  • Risk Adjustment Clinical

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The Risk Adjustment Clinical Documentation Specialist facilitates accurate, complete, consistent and ... medical record review. + Consistent and effective use of Compliant Documentation Management Program (CDMP) Risk Adjustment strategies. + Recognize opportunities… more
    St. Luke's University Health Network (08/26/25)
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  • Director, Operations

    UPMC (Pittsburgh, PA)
    …to BU including, but not limited to, professional licensure, registration and/or certification; risk management ; clinical operations and clinical ... to BU including, but not limited to, professional licensure, registration and/or certification; risk management ; clinical operations and clinical more
    UPMC (09/04/25)
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  • Senior Risk Management Specialist

    UPMC (Pittsburgh, PA)
    UPMC Corporate Legal is seeking a Senior Risk Management Specialist to join the team in Oakland, PA. This hybrid role offers a mix of onsite and remote work. ... Reporting to the Senior Manager, Corporate Risk Management , the role involves systematically managing...developing specific programs to address the needs of the clinical and management staff. Establish a working… more
    UPMC (08/08/25)
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  • Associate Medical Director, Pharmacovigilance…

    Sumitomo Pharma (Harrisburg, PA)
    …event coding, concomitant medication coding, and causality statements. + Contributes to Risk Management Plans (RMPs)/ Risk Evaluation and Mitigation Strategy ... in oncology is highly desired + **Advanced understanding of pharmacovigilance and risk management regulations and guidelines, including pre- and post-marketing… more
    Sumitomo Pharma (08/15/25)
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  • VP Risk Adjustment Accuracy…

    Highmark Health (Blue Bell, PA)
    …on providing optimal financial returns in a fully compliant manner. Develop a Risk Management governance strategy for the Enterprise to appropriately manage CMS ... Inc. **Job Description :** **GENERAL OVERVIEW:** This position is responsible for risk revenue management for all government program products (commercial ACA,… more
    Highmark Health (07/30/25)
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  • Senior Risk & Compliance Analyst

    Highmark Health (Harrisburg, PA)
    …address clinical , information security, privacy, and other areas of risk .Prepare draft reports and other management reporting deliverables.Review all work ... riskacross Highmark Health clinical areas to support clinical quality auditing, The Senior Risk Compliance...Compliance, and other teams across the Enterprise to align risk management objectives, practices and procedures. +… more
    Highmark Health (07/04/25)
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  • Director, Prospective + Concurrent Risk

    Datavant (Harrisburg, PA)
    …of product management experience in healthcare, including ownership of clinical , risk adjustment, or provider-facing solutions. + Proven leadership ... of service. This is a leadership role that combines strategic thinking, clinical product development expertise, and people management responsibilities. You'll be… more
    Datavant (08/08/25)
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