- Evolent (Harrisburg, PA)
- … Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with ... + Provides clinical rationale for standard and expedited appeals. + Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering… more
- Evolent (Harrisburg, PA)
- …as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. . Aids and acts as a resource to Initial ... reviews to be completed by the subject matter expert. . Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering providers,… more
- University of Pennsylvania (Philadelphia, PA)
- …Dean for Global Engagement, the Assistant Dean articulates admissions strategies for the program and participates in the representation of Penn Carey Law to a host ... aid and matriculation strategies, build classes of deep academic quality and broad geographical diversity. + Using a deep...sound analysis of complex data, recommend to the Dean program goals and admissions targets. + Design and manage… more
- PNC (Pittsburgh, PA)
- …You would additionally: * Serve as subject matter expert to assigned areas and review model documentation and model validation reports to determine if the models are ... audit reports and support general audit process and control review activities related to traditional audit work, as assigned....tight deadlines. * Prior experience an interest in providing peer mentorship, providing peer guidance and support… more
- Fresenius Medical Center (Philadelphia, PA)
- …values and customer service philosophy. Adheres to the FMCNA Compliance Program , including following all regulatory and FMS policy requirements. Ensure provision ... of quality patient care while maintaining cost-effective clinical operations in...programs. Adheres to all requirements of the FMCNA Compliance Program , and FMS patient care and administrative policies as… more
- Pacific Northwest National Laboratory (Harrisburg, PA)
- …hardware design tools, and advanced architecture testbeds. The expected outcomes involve high- quality research work represented by peer - review publications ... technologies + Participate in the development and publication of peer -reviewed publications to present the work + Develop methods...+ Candidates must be currently enrolled/matriculated in a PhD program at an accredited college. + Minimum GPA of… more
- CVS Health (Harrisburg, PA)
- …providers. As a Medical Director you will focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination reviews ... and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. This...Prior Authorization / Pre Certification / Concurrent Reviews / Peer to Peer Calls / First Level… more
- Charles River Laboratories (Horsham, PA)
- …of new information or design changes for upcoming studies * Provide internal QC via peer review * Assist SD in communicating study status to the Sponsor * ... scientific and administrative support and in the production of a high quality , accurate and timely study report. Essential Duties and Responsibilities * Assist… more
- UPMC (Media, PA)
- …professional and institutional providers of care. + Ability to implement programs of quality care analysis, peer review , and professional education. ... The Regional Medical Director is responsible for assuring the quality and efficiency of the health care delivered to...+ Advises the Regional Director on the development and review of programs, positions, and budgets having an impact… more
- University of Pennsylvania (Philadelphia, PA)
- …and various sponsors. This position will report directly to the GU Program Manager and work directly with Physician Investigators ("PI") on clinical research ... research protocols, including accurate data collection and overseeing the quality of the clinical trial data and records, scheduling...as directed by the ACC CRU GU Research Team Program Manager. + Be actively involved in planning and… more
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