Current jobs related to Regulatory Compliance and Utilization Review Specialist - Harrisburg Pennsylvania - Albright LIFE

  • Regulatory Affairs Specialist

    4 weeks ago

    Harrisburg, Pennsylvania, United States Integra LifeSciences Full time

    Join Integra LifeSciences as a Senior Regulatory Affairs SpecialistAt Integra LifeSciences, we are committed to creating a better tomorrow for patients and healthcare professionals. As a Senior Regulatory Affairs Specialist, you will play a critical role in ensuring the compliance of our products with regulatory requirements, while also contributing to the...

  • Environmental Compliance Specialist

    2 months ago

    Pennsylvania, United States Energix North America Full time

    Job SummaryEnergix North America is seeking a dedicated Environmental Compliance Specialist to oversee and manage environmental compliance across multiple construction sites in Pennsylvania.Key ResponsibilitiesConduct thorough inspections of solar construction sites to ensure compliance with state and local regulations, including the Department of...

  • Medical Director for Utilization Review

    1 week ago

    Harrisburg, Pennsylvania, United States Health Advocates Network Full time

    Job Summary:Health Advocates Network is seeking a highly skilled Primary Care Physician to serve as a medical director for utilization review. The ideal candidate will have expertise in family practice medicine and a strong understanding of utilization review processes.Key Responsibilities:• Conduct prospective, concurrent, and retrospective reviews of...

  • Regulatory Specialist

    4 weeks ago

    Harrisburg, Pennsylvania, United States Management Recruiters International Full time

    Regulatory Associate Job DescriptionOur boutique administrative law firm in Harrisburg, PA is seeking a skilled Regulatory Associate to join our team. This role will involve working in various areas of regulatory and administrative law, including energy, water, and transportation.Why Work with Us?Opportunity to take on challenges and grow with our...

  • Regulatory Law Specialist

    3 weeks ago

    Harrisburg, Pennsylvania, United States Offit Kurman Full time

    Healthcare Regulatory Attorney OpportunityOffit Kurman, a leading full-service law firm, is seeking an experienced Healthcare Regulatory Attorney to provide comprehensive regulatory counsel and ensure compliance with federal and state healthcare laws.About the Role:Our healthcare clients include a wide range of healthcare providers, specialty practices,...

  • Public Utility Enforcement Specialist

    2 weeks ago

    Harrisburg, Pennsylvania, United States Commonwealth of Pennsylvania Full time

    Unique Law Enforcement OpportunityAre you looking for a challenging and dynamic work environment? The Commonwealth of Pennsylvania is seeking a Public Utility Enforcement Officer to cover multiple counties. As a key member of our team, you will be responsible for enforcing laws and regulations related to public utilities.Key Responsibilities:Enforce laws and...

  • Medical Review Specialist

    2 weeks ago

    Harrisburg, Pennsylvania, United States TulaRay Full time

    Medical Review SpecialistWe are seeking a highly skilled Medical Review Specialist to join our team at TulaRay. As a Medical Review Specialist, you will be responsible for reviewing medical records and providing written decisions on continuity of care requests.Key Responsibilities:Review medical records and provide written decisions on continuity of care...

  • Regulatory Specialist, Nuclear

    2 weeks ago

    Middletown/Pennsylvania/US Constellation Energy Full time

    WHO WE AREAs the nation's largest producer of clean, carbon-free energy, Constellation is focused on our purpose: accelerating the transition to a carbon-free future. We have been the leader in clean energy production for more than a decade, and we are cultivating a workplace where our employees can grow, thrive, and contribute. Our culture and employee...

  • Water Utility Program Manager

    1 week ago

    Harrisburg, Pennsylvania, United States Veolia Full time

    Job DescriptionVeolia North America is seeking a highly skilled Water Utility Program Manager to join our team. This role will be responsible for implementing and managing the Lead and Copper Rule (LCR) Program and the Cross Connection Control/Backflow Prevention Program in Pennsylvania and Delaware.The ideal candidate will have a strong background in...

  • Medical Records Reviewer

    2 months ago

    Harrisburg, Pennsylvania, United States Highmark Health Full time

    Job SummaryWe are seeking a skilled Medical Records Reviewer to join our team at Highmark Health. As a key member of our coding team, you will be responsible for reviewing and interpreting medical information to determine accurate ICD and CPT codes for diagnoses and procedures.Key ResponsibilitiesReview and interpret medical records to abstract accurate data...

  • Regulatory Associate

    1 month ago

    Harrisburg, Pennsylvania, United States MRINetwork Jobs Full time

    Job OpportunityRegulatory AssociateOur client, a boutique administrative law firm in Harrisburg, PA, is seeking a Regulatory Associate to work in various areas of regulatory and administrative law, including energy, water, and transportation.Why Work with Us?Opportunity to take on challenges and grow professionallyCollaborate with experts in Pennsylvania...

  • Regulatory Associate

    1 month ago

    Harrisburg, Pennsylvania, United States MRINetwork Jobs Full time

    Job DescriptionRegulatory AssociateOur client, a boutique administrative law firm in Harrisburg, PA, is seeking a Regulatory Associate to work in various areas of regulatory and administrative law, including energy, water, and transportation. Why Work Here?Opportunity to take on challenges and grow your caseload Collaborate with experts in Pennsylvania...

  • Regulatory Associate

    1 month ago

    Harrisburg, Pennsylvania, United States MRINetwork Jobs Full time

    Job OpportunityRegulatory AssociateOur client, a boutique administrative law firm in Harrisburg, PA, is seeking a Regulatory Associate to work in various areas of regulatory and administrative law, including energy, water, and transportation.Why Work with Us?Opportunity to take on challenges and grow professionallyCollaborate with experienced experts in...

  • Regulatory Affairs Director

    1 week ago

    Harrisburg, Pennsylvania, United States J&J Family of Companies Full time

    Job Title: Regulatory Affairs DirectorJob Summary:We are seeking a highly skilled Regulatory Affairs Director to join our team at J&J Family of Companies. As a key member of our regulatory team, you will be responsible for developing and implementing regulatory strategies to ensure compliance with global regulations and guidelines.Key...

  • Clinical Reviewer Specialist

    2 weeks ago

    Harrisburg, Pennsylvania, United States Acentra Health Full time

    About Acentra HealthAcentra Health is a leading healthcare company that empowers better health outcomes through technology, services, and clinical expertise.Job SummaryWe are seeking a Clinical Reviewer to join our team. The successful candidate will utilize their clinical expertise to review medical records against appropriate criteria, applying critical...

  • Clinical Reviewer

    3 days ago

    Harrisburg, United States Acentra Health Full time

    CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company's mission, actively...

  • Utilization Management Clinician

    2 weeks ago

    Harrisburg, Pennsylvania, United States Capital BlueCross Full time

    Job SummaryCapital Blue Cross is seeking a highly skilled Utilization Management Clinician to join our team. As a key member of our Utilization Management department, you will play a critical role in ensuring that our members receive the necessary care and services to achieve optimal health outcomes.Key ResponsibilitiesConduct thorough clinical reviews of...

  • Clinical Utilization Manager

    4 weeks ago

    Harrisburg, Pennsylvania, United States Capital BlueCross Full time

    Job SummaryWe are seeking a highly skilled Clinical Utilization Manager to join our team at Capital BlueCross. As a key member of our Utilization Management department, you will play a critical role in ensuring that our members receive the most appropriate and effective care.ResponsibilitiesConduct thorough reviews of acute and post-acute inpatient and...

  • RN Sanction Specialist

    2 weeks ago

    Harrisburg, Pennsylvania, United States Acentra Health Full time

    Job Title: RN Sanction SpecialistAcentra Health is seeking a highly skilled RN Sanction Specialist to join our team. As a key member of our compliance team, you will be responsible for overseeing and directing all activities associated with the CMS Sanction process.Key Responsibilities:Maintain effective communication with BFCC QIO and healthcare...

  • Coder II Specialist

    1 month ago

    Harrisburg, Pennsylvania, United States Highmark Health Full time

    Job Summary:This role performs thorough medical record review to abstract medical and diagnoses and procedures utilizing ICD and CPT coding classification systems and encoder to meet financial, third-party, and federal/state regulatory standards.Key Responsibilities:Reviews and interprets medical information, physician treatment plans, courses, and outcomes...

Regulatory Compliance and Utilization Review Specialist

2 months ago

Harrisburg Pennsylvania, United States Albright LIFE Full time

Position Overview
The Regulatory Compliance and Utilization Review Specialist at Albright LIFE is tasked with overseeing utilization review functions and managing reporting protocols to ensure adherence to regulatory requirements while enhancing participant outcomes.

Key Responsibilities
This role is essential in:
1. Analyzing performance metrics to identify areas for improvement.
2. Facilitating collaboration among interdisciplinary teams.
3. Promoting the delivery of high-quality care within the PACE program.

Impact
Your contributions will play a vital role in ensuring compliance and improving the overall quality of care provided to participants.