- Select Medical (Hummelstown, PA)
- …Employer, including Disabled/Veterans_ Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/347230/ director -of- quality - management inpatient ... joint venture with Select Medical & Penn State Health** ** Director of Quality Management ** **(DQM)**...+ Customizable health insurance packages **Who We Are** Our inpatient rehabilitation hospital is committed to providing exceptional and… more
- Datavant (Harrisburg, PA)
- …life experiences to realize our bold vision for healthcare. As an ** Inpatient Auditing Specialist** you will be instrumental in addressing consulting and educational ... needs related to coding quality , compliance assessments, external payer reviews, coding education, interim coding management , and coding workflow operations… more
- Amergis (Bel Air, MD)
- …information pertinent to patient's needs/goals + Partners with the Program Director in development and review of the patient's individualized coordination of ... resources, information, and referrals for psychosocial needs + Participates in Quality Assurance and Utilization Review activities, as directed + Empowers patients… more
- Humana (Harrisburg, PA)
- …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare..., depending on the line of business. The Medical Director conducts Utilization Management or clinical validation… more
- Humana (Harrisburg, PA)
- …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Information** Typically reports to a Lead Medical Director . The Medical Director conducts post-service, inpatient care reviews for accurate billing of… more
- Humana (Harrisburg, PA)
- …participation in care management . The clinical scenarios arise from outpatient, inpatient or post-acute care environments. The Medical Director will have ... skills, with prior experience participating in teams focusing on quality management , utilization management , case...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care… more
- Humana (Harrisburg, PA)
- …analytic and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... communication of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise from inpatient or… more
- Oracle (Harrisburg, PA)
- …+ Clinical experience as a nurse or physician with a deep product management skills + Understanding of reimbursement and quality improvement processes as ... **Job Description** The Clinical Note AI Agent Product Management Leader will be responsible for defining and executing the global strategy for our rapidly expanding… more
- Humana (Harrisburg, PA)
- …+ Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services + Maintain accountability for productivity, quality , and ... of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Harrisburg, PA)
- …members of the Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...subject matter contribution Preferred Qualifications + Experience in an inpatient environment and/or related to care of a Medicare… more
- Humana (Harrisburg, PA)
- …members of the Medicare population and reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Wellpath (Lemoyne, PA)
- …training, education, and point of care support. **About this role** The Medical Director of Utilization Management leads and oversees utilization review, case ... management , quality improvement, and related policy and practice initiatives within...and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a… more
- Devereux Advanced Behavioral Health (West Chester, PA)
- **Description** ** Director of Finance** Are you a skilled senior finance professional with strong administrative skills? Do you have prior experience in a Health ... our team where you can take your career to the next level. **Being a Director of Finance at Devereux Pennsylvania Children's Services has its Advantages!** As the … more
- WellSpan Health (York, PA)
- …respected group who pride themselves in fulfilling their mission to provide excellent inpatient care. **Expectations of Medical Director include:** + Ability to ... Group's drive to ensure that care is of high quality and value and is integrated across the system....in south central Pennsylvania is seeking an Associate Medical Director to aid in leading the hospitalist program at… more
- WellSpan Health (Lebanon, PA)
- **General Summary** RN Provides clinical direction and management of activities related to the care management of assigned patient population, including clinical ... policy development and implementation, clinical data management and reporting, achieving clinical outcomes, improving cost effectiveness, and interdisciplinary… more
- Penn Medicine (West Chester, PA)
- …to systemwide Value Analysis Councils. Acting as a liaison among Materials Management , Physicians, Clinical Groups, Supply Chain, and System Leadership, the position ... & EMPLOYEE/ORGANIZATIONAL: + Meets regularly with hospital leadership and management to review product/equipment/supply issues and provide updates on resolution… more
- Evolent (Harrisburg, PA)
- …and refers cases that do not meet established clinical criteria to the Medical Director . + Appropriately identifies and refers quality issues to UM Leadership. + ... within the **RN/LVN/LPN** scope of practice, under the Medical Director 's direction, using independent nursing judgement and decision-making, physician-developed… more
- WellSpan Health (Ephrata, PA)
- …treatment plans, and policies; performs a variety of client care, case management and administrative functions; and completes details of the discharge plan and ... redirection, physical restraint and team crisis interventions. + Writes behavioral management plans for acute patients in cooperation with treatment team… more
- Penn Medicine (Lancaster, PA)
- …health system. There is an opportunity to work in varied clinical settings ( inpatient and outpatient) that may be tailored to the candidate's interests. The ... excellent interpersonal and communication skills. Clinical responsibilities include expert management of physical and emotional symptoms related to serious illness… more