Clinical Care Reviewer - Philadelphia, PA

The Clinical Care Reviewer is responsible for completing medical necessity reviews under the direction of the unit Supervisor. · ...

The Clinical Care Reviewer is responsible for completing medical necessity reviews using clinical knowledge and nursing experience. · Review provider requests for inpatient and outpatient services. · Pend requests for additional information and/or request clarification. · ...

We are seeking a Home Care Administrator to join our team. The Home Care Administrator will be responsible for overseeing the office facility and day to day operations. · ...

The Utilization Management Manager plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and in-house concurrent review authorizations. · This position blends strong relationship-building skills with clinical knowledge ...

We empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. · The Utilization Management Manager plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and i ...

The Utilization Management Manager plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and in-house concurrent review authorizations. · This position blends strong relationship-building skills with clinical knowledge ...

The Utilization Management Manager plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and in-house concurrent review authorizations. · ...

The Utilization Management Manager plays a vital role in ensuring patients have timely access to care by managing both front-end prior authorizations and in-house concurrent review authorizations.This position blends strong relationship-building skills with clinical knowledge to ...

We're excited to seek highly skilled Utilization Management Registered Nurses with strong backgrounds in oncology, infusion therapy, · & advanced clinical review to join our Infusion Therapy Team as Care Management Coordinators.This is an excellent opportunity for experienced UM ...

The Care Management Coordinator primary responsibility is to evaluate a member's clinical condition through the review of medical records (including medical history and treatment records) to determine the medical necessity for patient's services based on advanced knowledge and in ...

Job summary · The Pharmacy Technician on the Direct Ship Team plays a critical role in ensuring timely, · compliant, · and medically appropriate medication access for members. · ...

The Utilization Management Nurse is responsible for cost-effective quality utilization management in acute care settings. · Review clinical information provided by facilities. · Maintain timeliness of UM determinations. · ...

+ Manage department and college review process and other projects for the office of faculty affairs and office of the provost · + Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. · + Coordinate yearly department reviews, · + Compose se ...

This req will be for our General Precert team- training will be streamlined for PT/OT/ST requests and bariatric requests. · The Care Management Coordinator primary responsibility is to evaluate a member's clinical condition through the review of medical records (including medical ...

The Utilization Management Nurse is responsible for ensuring cost-effective and quality utilization management in the acute level of care setting. · Comprehensive package of benefits including medical, dental, vision insurance. · ...

We are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at risk populations. · ...

++The AR Coordinator is a pivotal role within the regional finance team,+acting as the primary liaison between the field operations and+the Central Billing Office (CBO). This position ensures+the timely and accurate management of accounts receivable,+facilitates the resolution of ...

Historic and exciting downtown Philadelphia seeks a Board Certified substance abuse/addictions experienced psychiatrist. · ...

The Advanced Practice Provider plays a crucial role within ambulatory care environment collaborating closely with multidisciplinary healthcare team. · ...

We are seeking an experienced Care Management Coordinator (RN) to support Utilization Management and Care Coordination in a high-impact, fully remote role. · This position plays a critical role in ensuring members receive the right care, at the right time, in the right setting, w ...