• Provider Network Audit

    CVS Health (Harrisburg, PA)
    …systems and on daily operations and programs + Responsible to support targeted quality audit projects. Report results and make recommendations eg, training ... service to our internal and external customers. **Position Summary** + Performs routine quality audits for network operations and claim testing for PPO … more
    CVS Health (06/01/25)
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  • Behavioral Health Clinical Quality

    Elevance Health (Seven Fields, PA)
    **JR152864 Behavioral Health Clinical Quality Audit Analyst Sr** This role is primarily focused on conducting medical record reviews of facilities and clinics in ... our network . The candidate must be willing and able to...locations. Additional responsibilities may include conducting investigations into potential quality of care concerns, participating in on-site quality more
    Elevance Health (05/31/25)
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  • Lead Auditor, IT Audit

    Guardian Life (Bethlehem, PA)
    Internal Audit 's mission is is to provide ...to proactively manage risk. + Prepare clear, concise, high quality audit reports and other audit ... the Head of Infrastructure, Cybersecurity and Data/AI - Internal Audit , this position functions as a working IT ...team. This job is predominately focused on performing high quality , value-add, assurance services that identify, evaluate and report… more
    Guardian Life (04/03/25)
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  • Audit Senior Associate I

    Grant Thornton (Philadelphia, PA)
    POSITION SUMMARY Audit Senior Associate: Work with private and public companies to first understand their businesses and the risks they face, focusing efforts where ... managing to budget. + Supervise, train, and mentor associates and interns on audit process and assess performance of staff for engagement reviews; perform in-charge… more
    Grant Thornton (05/21/25)
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  • Audit Senior Associate III

    Grant Thornton (Philadelphia, PA)
    As an Audit Senior Associate, you'll listen to learn about your client's operations, processes, business objectives, and risks, and apply that knowledge to enhance ... the financial statement audit - all with the resources, environment and support...backed by powerful technologies and a roster of 12,000 quality -driven professionals enjoying exceptional career-growth opportunities and a distinctive… more
    Grant Thornton (04/02/25)
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  • Coding Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …works with staff assisting with clerical and administrative tasks related the appeals/ audit function. Identify and provide feedback, including identification of ... from record, supporting clinical evidence, and the coding argument, to support network coding. Develop and apply appeal arguments to defend the coding assigned… more
    St. Luke's University Health Network (05/19/25)
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  • Trauma Performance Improvement Coordinator

    St. Luke's University Health Network (Bethlehem, PA)
    …Program Medical Director (TPD) and the Trauma Program Manager (TPM) in improving quality of trauma care throughout the continuum. Collaborates with the TPD and the ... Trauma Program Medical Director who will be ultimately responsible for the quality improvement program. Effective continuous quality improvement programs depend… more
    St. Luke's University Health Network (04/08/25)
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  • Per Diem Diagnosis/Oasis Specialist

    St. Luke's University Health Network (Bethlehem, PA)
    …admitting clinician either verbally or through written methodology to validate audit findings and recommend additional and/or more specific documentation. + Works ... + Maintains accuracy rate of coding data as measured through quarterly quality reviews. + Consistently meets established productivity targets for coding assignment… more
    St. Luke's University Health Network (03/08/25)
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  • Psychology Manager (LPM) DOC - Expert

    Health Advocates Network (Somerset, PA)
    …Licensed Psychologist required. Role Description: Primary purpose of the position is to provide clinical supervision to front line Master's level clinicians and to ... provide clinical programmatic management and oversight of a Psychology...is responsible to participate in the SCI's monthly multidisciplinary quality improvement meeting. Duties also include the clinical and… more
    Health Advocates Network (05/21/25)
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  • Supplier Quality Specialist

    Catalent Pharma Solutions (Philadelphia, PA)
    …managing or completing tasks that support the Global Comparator and Depot Supplier Quality Management and Clinical Packaging Network site Supplier Programs. They ... and participate or lead in the maintenance of the audit schedule and approved supplier list. **This is a...+ Manage the approved supplier list for Global Supplier Quality and network supplier programs + Plan,… more
    Catalent Pharma Solutions (05/01/25)
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