• Director Risk Adjustment, Coding & Quality

    Highmark Health (Pittsburgh, PA)
    …to deliver the highest quality of care to Highmark members and improve clinical documentation accuracy and completeness. Creates a culture focused on Compliance and ... with Highmark cross-functional teams including Care Management, STARS, Compliance, clinical leadership of health systems, physicians and vendors to develop… more
    Highmark Health (08/08/25)
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  • Field Case Manager, Registered Nurse (Danville,…

    CVS Health (Bensalem, PA)
    …an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. ... and strategies, policies and programs are comprised of network management, clinical coverage, and policies. Community Care Case Manager's use a collaborative… more
    CVS Health (08/08/25)
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  • Auditor, HCC Risk Adjustment Coding - Full Time…

    Datavant (Harrisburg, PA)
    …and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of ... (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC ). + Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare,… more
    Datavant (08/08/25)
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  • Physician Educator Health Plan- Remote w/ travel

    UPMC (Pittsburgh, PA)
    …education of providers/practices related to risk adjustment, coding, and clinical documentation improvement. + Assess workflow processes in physician practices ... 5 years of experience in professional services, including practice management, nursing, clinical documentation improvement or quality audit. + 2-3 years of teaching… more
    UPMC (08/08/25)
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  • Ambulatory Coding and Doc Specialist

    Penn Medicine (Bala Cynwyd, PA)
    …mission of providing the highest level of care to patients, conducting innovative research , and educating future leaders in the field of medicine. Working for this ... leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn Medicine, someone… more
    Penn Medicine (08/07/25)
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  • PRN Clin Resource Coordinator WEEKDAYS

    Penn Medicine (Philadelphia, PA)
    …mission of providing the highest level of care to patients, conducting innovative research , and educating future leaders in the field of medicine. Working for this ... leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn Medicine, someone… more
    Penn Medicine (08/07/25)
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  • HCC Risk Adjustment Auditor - Full Time - Remote

    Datavant (Harrisburg, PA)
    …and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of ... (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC ) + A strong knowledge base of medical terminology, medical abbreviations, pharmacology,… more
    Datavant (08/01/25)
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  • Clinical Relief Pool Crisis Walk In Center

    Trinity Health (Pittsburgh, PA)
    …**Description:** **Position Purpose:** The Clinical Relief Pool Staff provides as-needed clinical support at the Central Recovery Center ( CRC ), a facility ... mental health or substance use crises. + Complete intake evaluations, clinical assessments, and documentation in accordance with agency and regulatory standards.… more
    Trinity Health (07/22/25)
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  • Field Case Manager

    Sedgwick (Erie, PA)
    …environment, who are driven to deliver great work. + Apply your medical/ clinical or rehabilitation knowledge and experience to assist in the management of ... services field required with one of the following certifications: CCM, CDMS, or CRC . Valid driver's license required. High speed internet required. **TAKING CARE OF… more
    Sedgwick (06/29/25)
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  • Senior Client Coding Project Manager

    Datavant (Harrisburg, PA)
    …years managing coders in an outpatient or inpatient setting. + Current CCS, CRC , or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, ... Commercial RA, and HEDIS experience. + Familiarity with HIPAA patient privacy requirements. + Excellent communication and organizational skills. + Keen attention to detail. + Advanced problem-solving skills. + Proficient in Microsoft Office and G-Suite… more
    Datavant (06/28/25)
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