• Healthcare Clinical Documentation Specialist

    Deloitte (Philadelphia, PA)
    …+ Experience as clinical registered nurse, physician, physician assistant, case manager , clinical documentation specialist, utilization review, informatics RN, ... Quality, DRG Validation and health IT preferred + Knowledge of Medicare reimbursement system and coding structures preferred + In-depth knowledge and experience in medical terminology, medical coding, and ICD-10-CM/PCS, IPPS payment system is a plus' +… more
    Deloitte (11/21/25)
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  • Strategic Pharmacy Analyst

    RxBenefits (Philadelphia, PA)
    …correct and released. Job Responsibilities Include: + Operate as the central project manager for the business on new opportunity prospects, playing a pivotal role in ... schedules, channel management, B/G classifications, specialty designations, rebate eligibility, utilization trend, Utilization Management (UM) implications, Manufacturer… more
    RxBenefits (12/04/25)
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  • Supervisor, Clinical RN -Emergency Services - Full…

    Guthrie (Sayre, PA)
    …staff, exhibiting the Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and leadership training within the Guthrie ... Robert Packer Hospital. May be assigned to special projects per Clinical Manager / Director consistent with strategic, fiscal, quality and operational goals/targets.… more
    Guthrie (01/06/26)
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  • Physical Therapist

    Battelle Memorial Institute (Harrisburg, PA)
    …Athletic Trainer (ATC) within their scope of practice as directed by HP program Manager and/or Coordinator + Participate in periodic meetings with HP and POTFF for ... + Serve as an advisor to the HP program Manager and/or Coordinator in matters related to injury prevention,...of care + Provide input for the development and utilization of required databases + Conduct peer record reviews… more
    Battelle Memorial Institute (12/30/25)
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  • Lead Respiratory Therapist (RT)

    Genesis Healthcare (York, PA)
    …Responsibilities The Lead Respiratory Therapist is responsible for assisting the Vent Manager / District Manager in the efficient management of respiratory ... respiratory services. 1. Is the back-up for the Vent Manager / District Manager in his/her absence. 2....of the highest standard of respiratory services through appropriate utilization of resources, the promotion of clinical programs, and… more
    Genesis Healthcare (11/26/25)
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  • Nurse Clinical Care Coordinator -Allegheny County

    UPMC (Pittsburgh, PA)
    …based on education and nursing experience for Sr. Professional Care Manager within the Community and Ambulatory Services Division. Responsibilities: + Provides ... healthy lifestyles, closes gaps in care, reduces unnecessary ER utilization and hospital admissions/readmissions, and manages social determinants of health.… more
    UPMC (12/31/25)
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  • Clinical Auditor/Analyst Intermediate - Remote

    UPMC (Pittsburgh, PA)
    …services related to clinical guidelines, coding requirements, regulatory requirements, and resource utilization . This role also acts as a SME for the department in ... but are not limited to analysis of controlled substance prescribing and utilization to identify potential clinical care issues; prepayment review of claims, and… more
    UPMC (01/06/26)
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  • Transplant Care Nurse (Remote)

    Highmark Health (Harrisburg, PA)
    …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans to… more
    Highmark Health (12/04/25)
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  • Regional Payer Account Director - Mid Atlantic

    Organon & Co. (Plymouth Meeting, PA)
    …as well as other extended account team members to maximize appropriate utilization of Organon products. Integrates Senior Leadership into the overall business ... regional level, as required. Leads Organon 's efforts to maximize appropriate utilization of its portfolio while bringing resources and solutions to customers that… more
    Organon & Co. (11/25/25)
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  • Supervisor - Home Health - West Region - Days

    WellSpan Health (York, PA)
    …current programs and policies. Assumes the responsibilities of the Clinical Manager as designated. **Duties and Responsibilities** **Essential Functions:** + Related ... required.* Identifies un-met patient needs and reports findings to appropriate Clinical Manager .*Completes S1 and CRS as needed. Completes 4C with team members to… more
    WellSpan Health (11/29/25)
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