- Evolent (Harrisburg, PA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely… more
- Oracle (Harrisburg, PA)
- …deployment, and operational excellence within the team . Coach, mentor, and review work from less-senior engineers, fostering a culture of collaboration and growth ... placed into the range based on the preceding factors as well as internal peer equity. Oracle US offers a comprehensive benefits package which includes the following:… 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 ... rationale for standard and expedited appeals. + Discusses determinations ( peer to peer phone calls) with requesting...(NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Harrisburg, PA)
- …and provides clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. . Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. . Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Harrisburg, PA)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… 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 ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...expedited appeals. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Harrisburg, PA)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Fresenius Medical Center (Dallas, PA)
- …+ Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. + Responsible for strong Director and physician ... Quality policies and procedures are communicated to and implemented by the facility staff . + Maintains integrity of medical records and other FMS administrative… more
- YesCare Corp (Philadelphia, PA)
- …annually. + Lead quality improvement initiatives, including patient complaints, infection control, peer review , and chart audits. + Oversee referrals to external ... and Automated External Defibrillator (AED) use, maintaining required certifications. + Lead medical staff meetings and provide monthly in-service education for … more
- UPMC (Media, PA)
- …Ability to maintain effective professional liaison with all levels of executive and medical staff , including professional and institutional providers of care. + ... a qualified individual to fulfill the role of Regional Medical Director in Delaware County, PA. The Regional ...Ability to implement programs of quality care analysis, peer review , and professional education. **Licensure, Certifications,… more