Current jobs related to R&E Nurse- Med Care Services- Expert - Harrisburg - Staff Today Inc
-
R&E Nurse- Med Care Services- Advanced
1 month ago
Harrisburg, United States Staff Today Inc Full timeJob DescriptionJob DescriptionR&E Nurse- Med Care Services- AdvancedPay Rate: $30 / hour*W2Minimum QualificationsPossession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing;or Possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing. Resources possessing...
-
R&E Nurse- Med Care Services- Advanced
1 month ago
Harrisburg, United States Staff Today Inc Full timeJob DescriptionJob DescriptionR&E Nurse- Med Care Services- AdvancedPay Rate: $30 / hour*W2Minimum QualificationsPossession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing;or Possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing. Resources possessing...
-
Medical Care Services Expert
4 weeks ago
Harrisburg, Pennsylvania, United States Della Infotech, Inc. Full timeJob SummaryWe are seeking a highly skilled Medical Care Services Expert to join our team at Della Infotech, Inc. As a key member of our Medical Assistance Program, you will be responsible for reviewing and evaluating medical information to ensure that eligible recipients receive appropriate and quality medical care.Key ResponsibilitiesReview and evaluate...
-
Vice President, R&D Consulting Expert
4 weeks ago
Harrisburg, Pennsylvania, United States Clarivate Analytics Full timeAbout the RoleWe are seeking a seasoned Vice President to lead our global R&D consulting practice at Clarivate Analytics. As a key member of our Life Sciences Consulting group, you will be responsible for driving the strategy, growth, and financial performance of our R&D Consulting practice.Key ResponsibilitiesManage the R&D consulting profit and loss,...
-
Travel Nurse RN Med Surg
2 weeks ago
Harrisburg, Pennsylvania, United States Supplemental Health Care Full timeJob Title: Travel Nurse RN Med SurgSupplemental Health Care is seeking a skilled Travel Nurse RN Med Surg to join our team in Camden, South Carolina.Job Summary:We are looking for a highly motivated and experienced Medical-Surgical Registered Nurse to provide high-quality patient care in a fast-paced hospital setting. As a Travel Nurse RN Med Surg, you will...
-
Nurse Expert
4 weeks ago
Harrisburg, Pennsylvania, United States UPMC Full timeJob SummaryWe are seeking a highly skilled and experienced Nurse Expert to join our team at UPMC. As a Professional Staff Nurse, you will be responsible for providing high-quality patient care and leading our team with expertise and compassion.About the RoleThe BSN Expert will be responsible for managing and providing patient care activities for a group of...
-
Nurse Expert
4 weeks ago
Harrisburg, Pennsylvania, United States UPMC Full timeJob SummaryWe are seeking a highly skilled and experienced Nurse Expert to join our team at UPMC. As a Professional Staff Nurse, you will be responsible for providing high-quality patient care and leading our team in delivering exceptional outcomes.About the RoleThe BSN Expert will be responsible for managing and providing patient care activities for a group...
-
Travel Nurse RN ED
1 month ago
Harrisburg, Illinois, United States Uniti Med Full timeJob Title: Travel Nurse RN EDUniti Med is seeking a skilled travel nurse to join our team in Harrisburg, Illinois.Job DetailsSpecialty: Emergency DepartmentDiscipline: Registered Nurse (RN)Duration: 13 weeksShift: 12 hours, nightsEmployment Type: TravelAs a travel nurse with Uniti Med, you will have the opportunity to work in a dynamic and fast-paced...
-
Information Technology Security Manager
1 month ago
Harrisburg, Pennsylvania, United States e&e IT Consulting Services, Inc. Full timeJob Title: Information Technology Security Managere&e IT Consulting Services, Inc. is seeking a highly skilled Information Technology Security Manager to join our team in Harrisburg, PA.Job Summary:The Information Technology Security Manager will be responsible for administering various aspects of the wired and wireless data network and infrastructure. This...
-
Travel Nurse RN ED
1 month ago
Harrisburg, Illinois, United States Uniti Med Full timeJob OpportunityUniti Med is seeking a skilled travel nurse to join our team in Harrisburg, Illinois.Job DetailsSpecialty: Emergency DepartmentDiscipline: Registered Nurse (RN)Duration: 13 weeksShift: 12 hours, nightsEmployment Type: TravelAs a travel nurse with Uniti Med, you will have the opportunity to work in a dynamic and supportive environment, with a...
-
Technical Expert
2 weeks ago
Harrisburg, Pennsylvania, United States CapB InfoteK Full timeJoin CapB InfoteK as a Technical SpecialistCapB InfoteK is a global leader in IT Solutions and Managed Services. Our R&D focuses on delivering cutting-edge products and solutions across digital transformations, including cloud, AI/ML, IoT, blockchain, and more.We are seeking a Technical Specialist to join our team on a salaried or contract basis. As a...
-
Smart Buildings Expert
1 week ago
Harrisburg, Pennsylvania, United States Siemens Corporation Full timeWe are seeking a talented Smart Buildings Expert to join our team at Siemens Corporation. As a Smart Buildings Expert, you will play a key role in our Smart Buildings Internship Program, where you will have the opportunity to develop your skills and knowledge in the field of smart buildings and sustainable infrastructure.The Smart Buildings Expert will be...
-
Harrisburg, Pennsylvania, United States Skyline Med Staff Nursing Full timeJob Description & RequirementsSkyline Med Staff Nursing is seeking a skilled Long Term Acute Care Registered Nurse for a travel nursing assignment.Specialty: Long Term Acute CareDiscipline: RNDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelThe ideal candidate will have experience in a Long Term Acute Care setting, with a...
-
Nurse Expert
2 weeks ago
Harrisburg, Pennsylvania, United States UPMC Full timeUnlock Your Nursing Potential with UPMCAt UPMC, we're committed to investing in our nurses - financially, personally, and professionally. As a Professional Staff Nurse, BSN, Expert, you'll have the opportunity to advance your career and make a meaningful impact on patient care.What We Offer:Competitive Compensation: Eligible candidates can earn a sign-on...
-
Expert ICU Nurse
6 days ago
Harrisburg, Pennsylvania, United States UPMC Full timeAt UPMC, we're committed to investing in our nurses – financially, personally, and professionally – from day one of their career.We believe in empowering our nurses to succeed and thrive in their careers, and we're dedicated to providing the support and resources they need to excel.Here's how we support our nurses:Generous Sign-On Bonus of up to $15,000...
-
Human Services Policy Analyst
2 weeks ago
Harrisburg, Pennsylvania, United States Abel Personnel Full timeJob DescriptionAs a Human Services Policy Analyst at Abel Personnel, you will play a key role in shaping the future of child welfare and youth services in Pennsylvania. This is a unique opportunity to make a lasting impact on the lives of children and families.Key Responsibilities:Master the Title IV-E reimbursement system to drive effective policy...
-
Nurse Expert
1 week ago
Harrisburg, Pennsylvania, United States UPMC Full timeUnlock Your Nursing Potential with UPMCAre you a dedicated and compassionate nurse looking to take your career to the next level? Do you have a passion for delivering exceptional patient care and leading by example? If so, we invite you to join our team of nursing professionals at UPMC.About the RoleAs a Professional Staff Nurse, BSN, Expert, you will be...
-
Expert Cardiothoracic Nurse Specialist
2 weeks ago
Harrisburg, Pennsylvania, United States UPMC Full timeJoin UPMC's Team of Expert NursesAt UPMC, we're committed to investing in our nurses - financially, personally, and professionally. We offer a range of benefits to support your career growth and well-being, including:Generous sign-on bonuses of up to $15,000Up to five and a half weeks of paid time off annually, plus seven paid holidays each yearDedicated...
-
Travel Nurse RN ED
2 weeks ago
Harrisburg, Illinois, United States Uniti Med Full timeJob Opportunity: Travel Nurse RN EDUniti Med is seeking a skilled travel nurse to join our team in Harrisburg, Illinois.About the JobSpecialty: Emergency DepartmentDiscipline: Registered Nurse (RN)Shift: 12 hours, nightsEmployment Type: TravelThe ideal candidate will have experience working in emergency departments and be able to provide high-quality patient...
-
Information Technology Security Manager
1 month ago
Harrisburg, United States e&e IT Consulting Services, Inc. Full timee&e is seeking a Information Technology Security Manager for a onsite contract opportunity in Harrisburg, PA!The Manager of IT Security will be responsible for the following tasks:• Assists with administration of many aspects of the wired and wireless data network and infrastructure.• Manages network access control system, Patching, Vulnerability...
R&E Nurse- Med Care Services- Expert
3 months ago
Pay Rate: $34 / hour
*W2
Minimum Qualifications
Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing;or Possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing. Resources possessing non-renewable temporary practice permits must obtain licensure as a Registered Nurse within the one-year period as defined by the Pennsylvania State Board of Nursing.
Proficient writing and basic Computer Skills to include, but not limited to, Microsoft Office Products
Three years of professional experience with medical assistance (MA), health care services, or human services
Minimum of three years of recent (within the last five years) professional experience in one or more of the following areas as related to the position need: long term care, acute care setting, behavioral health setting, drug and alcohol setting, managed care, quality management/utilization review or other related clinical experience;or
An equivalent combination of experience and training in the field of medical assistance (MA), health care services, human services, long term care, utilization review, or knowledge of home care
Knowledge of and familiarity with the following would be beneficial: Inter- Qual criteria, ICD-9 CM, and current procedure terminology,
Ability to use professional judgment in identifying aberrant patterns and determining the appropriate action to be taken following the documentation review.
Role Description:
This is work in the review and evaluation of the medical necessity, appropriateness, quality, quantity, adequacy, and compensability of medical care and services rendered by service providers under the Medical Assistance Program. A resource is responsible for the review and evaluation of medical information and examination of medical records and other documentation to assure that eligible medical assistance recipients receive appropriate and quality medical care that the Medical Assistance Program is properly billed, and that provider and/or recipient fraud and abuse of the Medical Assistance Program is detected and corrected. Work involves the analysis and evaluation of documentation submitted by Medical Assistance Program service providers and generated through PROMISe'in order to make professional medical judgments regarding the appropriateness of the care and services provided to eligible recipients under the Medical Assistance Program. Reviews may be conducted in central office with the Medical Assistance Program service provider furnishing the necessary medical records, on site at the facility, or information may be provided over the telephone for any service that may require prior authorization or post certification. Work may include serving as a team leader on reviews requiring more than one staff member organizing and coordinating the review process. Resources also provide advisory and consultative services to boards and staff designed to improve the services or administrative procedures in support of medical assistance patients. Work may also involve the resource representing the Department in an official capacity during an appeal process. Judgment and discretion are required in conferring with advisory boards, facility officials, providers, and staffs. Work is performed under the supervision of an administrative superior and is reviewed through conferences and reports.
ESSENTIAL JOB FUNCTIONS*
Ability to prepare correspondence and reports.
Ability to comprehend and apply regulations, policies and standards. Ability to establish and maintain effective working relationships. Ability to carry out instructions and complete assignments. Ability to conduct field work, desk and telephonic reviews.
Ability to travel to facilities/provider sites to conduct reviews and attend training and meetings as needed, across the State (includes overnight stays). Ability to communicate effectively (verbally and in writing) with coworkers, management, Office of General Counsel other agencies, nursing facility staff and other medical assistance providers to review and discuss cases.
Ability to enter essential data into the computer.
Ability to physically traverse stairs, lift laptop, printer and related equipment, walk long distances and sit for long periods of time.
Ability to review and evaluate provider documentation to determine compliance with Medical Assistance regulations.
Ability to testify at administrative/legal hearings and to defend Departmental decisions.
Ability to maintain discretion and confidentiality.
*Essential Job Function: A necessary and fundamental job duty associated with the position.
Refer friends, Earn rewards Https://stafftoday.Staffingreferrals.Com/join/ncampos
#ZipRecruit
