- Highmark Health (Harrisburg, PA)
- …with all compliance, regulatory and contractual requirements. Conducts ongoing audit review programs, develops tools to assess current outcomes and trends along ... as outcome of Quarterly State Audit Reviews, Annual MERCER Review and NCQA Review . Develops ongoing educational...in Social Work **LICENSES OR CERTIFICATIONS** **Required** + Registered Nurse or + Licensed Clinical Social Worker (LCSW) -… more
- Geisinger (State College, PA)
- …patient's reason for visit, weight, vital signs, visit screening information, medication review , and pertinent information for provider. + Sets up examination and ... Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.… more
- Geisinger (Shamokin, PA)
- …Program (EAP): Referrals for childcare, eldercare, & pet care; Access free legal guidance, mental health visits, work-life support, digital self-help tools and more ... indemnity insurance, identity theft protection, universal life and pet and legal insurance + Shared governance structure that empowers our Respiratory Therapists… more
- Highmark Health (Erie, PA)
- …**ESSENTIAL RESPONSIBILITIES:** + Perform complete, detailed and accurate histories, review patient records and perform complete physical examinations. + Order ... 60 days of hire + National Board Certification for Nurse Practitioners through the American Academy of Nurse...Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in… more
- St. Luke's University Health Network (Bethlehem, PA)
- …of the service line(s), in reference to the physician assistants and nurse practitioners (APs), and/or AP provider group. Partners with service line's physician ... 18. Participates and contributes to service line operations, clinical review /development, and performance improvement/quality committees and/or meetings 19. Facilitates… more
- UPMC (Williamsport, PA)
- …sound judgment and coordinate with appropriate departments such as Risk Management, Legal , and Patient Relations. + Mentorship & Development:Serve as a mentor and ... + Must maintain a solid/strong performer rating on annual performance review **Licensure, Certifications, and Clearances:** Current Pennsylvania licensure as a… more
- Oracle (Harrisburg, PA)
- …engagement, and leadership skills. **Preferred Qualifications:** + Clinical experience as a nurse or physician with a deep product management skills + Understanding ... Gather and analyze information to define product specifications and review design specifications. Envision and communicate product strategy and functionality.… more
- Highmark Health (Harrisburg, PA)
- …SUMMARY** This job implements the effective utilization management strategies including: review of appropriateness of health care services, application of criteria ... interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established industry and… more
- Highmark Health (North Versailles, PA)
- …the patients to assess current state, collaboratively set goals, and review the after-visit summary. Instructs the patient on condition management, behavioral ... and follows up for ongoing activation. (10%) + Performs registry and quality data review and conducts population outreach to close gaps in care. (10%) + Oversees the… more
- St. Luke's University Health Network (Bethlehem, PA)
- …care. The Admission's Clinical Reviewer is responsible for the comprehensive medical review and screening of all referrals made to the inpatient Acute Rehabilitation ... all inquiries for admission to ARC + Completes thorough review of documentation and information and assesses a patient's...a post-acute rehabilitation setting preferred. Clinical experience as a nurse or therapist in an inpatient setting for a… more