- CenterWell (Harrisburg, PA)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...on excellent service to others. **Required Qualifications** + Active RN license + Possession of or ability to obtain… more
- CenterWell (Harrisburg, PA)
- …and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain… more
- Intermountain Health (Harrisburg, PA)
- …and collaborates with Clinical Documentation Integrity (CDI) Registered Nurses ( RN ) and Intermountain Physician Advisors to review complex facility ... optimization of reviews while patients are hospitalized. It aids in the review of quality measures including Patient Safety Indicators and Hospital Acquired… more
- Penn Medicine (Philadelphia, PA)
- …and/or specification to reflect truth in diagnostic reflection. Responsibilities: + Direct review of patient charts to audit clarity and full reflection of severity ... efficiencies/synergies within the Clinical Documentation department + Enter clinical review data and related anticipated follow-up in EPIC PENN...a resource on DRG issues Credentials: + RHIA or RN (Preferred) + CCDS or CDIP or RN… more
- BAYADA Home Health Care (Norristown, PA)
- …our clients. Jefferson Health at Home by BAYADA is currently seeking an experienced clinician ( RN , LPN, OT, OTA, PT, PTA, or Social Worker) to fill the position of ... facilities to coordinate the initiation of home health care ( Medicare ) services. This will be a hybrid role. The...of clinical and regulatory home care eligibility criteria. + Review all medical documentation and work with physicians to… more
- St. Luke's University Health Network (Bethlehem, PA)
- …and/or sites. JOB DUTIES AND RESPONSIBILITIES: + Performs admission review on all rehabilitation patients that identifies psycho-social barriers, interventions ... Participates in daily "stand-up" meetings with the interdisciplinary team to briefly review patient progress and provide updates on information relevant to the… more
- CenterWell (Harrisburg, PA)
- …off-days during the week.** The **Clinical Care Coordinator/Care Manager, Telephonic Nurse ** helps to ensure optimal continuity of care for patients transitioning ... and under established performance criteria. This is a work-from-home telephonic nurse position **Essential Functions:** + Act as CenterWell Home Health… more
- LifePoint Health (Johnstown, PA)
- …in all areas of care management to include utilization review , transition/discharge planning, social work services. Provide specialized expertise, ensure ... basis protected by applicable federal, state or local law. . REQUIRED: RN license . Bachelor's Degree in Nursing or Healthcare Administration. Masters Preferred… more
- Healthfirst (PA)
- …the care plan for assigned members and conducts pre-certification, concurrent review , discharge planning, and case management as assigned. The Case Manager, ... necessary + Additional duties as assigned Minimum Qualifications: + RN , LPN, LMSW, LMHC, LMFT, LCSW, PT, OT, and/or...Interqual and/or Milliman knowledge + Knowledge of Centers for Medicare & Medicaid Services (CMS) or New York State… more