Clinical Authorization Advisor

**Clinical Expertise Opportunity at Temple Health**As a clinical advisor, you will play a crucial role in providing medical expertise and guidance to our Clinical Analysis and appeals team. This position requires strong working knowledge of the Interqual Criteria Set and hospital reimbursement systems. You will be responsible for acting as the physician...

At Community Behavioral Health, we are committed to providing high-quality care to our members. As a Physician Advisor, you will play a critical role in ensuring that our clinical management practices align with best practice standards and state regulatory requirements.">Performs physician reviews of member cases to ensure medical necessity and quality of...

Temple University Hospital is seeking a skilled Nursing Authorization Specialist to join our team.About the RoleThis position plays a vital role in ensuring efficient and effective authorization processes for patients undergoing treatment at Temple University Hospital. As a key member of the Pre-Certification Department, you will serve as the primary...

Job Summary:">We are seeking a highly skilled and detail-oriented Clinical Liaison Specialist to join our team. In this role, you will be responsible for obtaining insurance precertification/recertification, serving as a liaison with third-party payers, communicating clinical information to insurance companies, addressing and resolving actual or potential...

Company OverviewLifelancer is a talent-hiring platform in Life Sciences, Pharma and IT that connects professionals with opportunities in pharma, biotech, health sciences, healthtech and IT domains.The company aims to bridge the gap between skilled individuals and organizations seeking their expertise. By leveraging technology, Lifelancer facilitates...

**About the Role:**We are seeking a highly skilled Physician Advisor to join our team at Temple University Hospital. As a key member of our team, you will provide clinical expertise and guidance to our Clinical Analysis and appeals team.The ideal candidate will have a strong working knowledge of the Interqual Criteria Set and hospital reimbursement systems....

About the RoleWe are seeking a highly skilled Clinical Care Manager to join our team at Community Behavioral Health. As a Clinical Care Manager, you will be responsible for utilizing your clinical knowledge and expertise to ensure CBH members receive timely access to quality, medically necessary behavioral health services.Estimated Salary: $65,000 - $85,000...

About the RoleAs a Lead Scientific Advisor at Clario, you will be responsible for supporting the sales and delivery of our electronic clinical outcome assessment (eCOA) services. You will provide scientific expertise and recommendations related to the sale and delivery of eCOA services, including protocol and solution review and COA/eCOA strategy.Key...

**Job Summary:**We are seeking a highly skilled Physician Advisor to provide clinical expertise and guidance to our Clinical Analysis and appeals team. As a key member of our team, you will act as the physician advisor for medical necessity appeals and for the Pennsylvania Medical assistance (PAMA) utilization reviews.The ideal candidate will have a strong...

Job Summary:We are seeking a highly skilled and experienced Senior Clinical Care Coordinator to join our team at Community Behavioral Health (CBH). As a key member of our staff, you will play a critical role in ensuring that our members receive timely access to quality, medically necessary behavioral health services.About the Role:The Senior Clinical Care...

Job DescriptionThe Community Behavioral Health (CBH) Clinical Care Manager – Neurodevelopmental Services is a crucial role that involves utilization management, population management, cross-system consultation, provider management, and treatment quality monitoring.Key ResponsibilitiesConduct utilization review activities, including interagency meetings,...

Job OverviewCommunity Behavioral Health (CBH) seeks a dedicated and compassionate Clinical Care Management Professional to join our team. As a key member of our Complex Care team, you will play a vital role in providing high-intensity care management to children and families in need. This is an exciting opportunity to make a meaningful difference in the...

Job Title: Care Coordination SpecialistAbout the Role:Care Coordination Specialists at Community Behavioral Health are responsible for coordinating care activities and collaborating with stakeholders involved in a member's case. This includes utilization management, population management, cross-system consultation, and treatment quality monitoring.Key...

About the RoleWe are seeking a skilled Clinical Care Manager to join our team at Community Behavioral Health. As a key member of our team, you will be responsible for managing the care of our members, ensuring they receive timely access to quality, medically necessary behavioral health services.The successful candidate will possess a Master's degree in...

At Temple University Hospital, we are seeking a highly skilled and experienced Clinical Utilization Review Specialist to join our team. In this role, you will serve as the primary clinical resource in the Pre-certification Department, handling complex authorization issues with expertise and precision.Serving as the primary liaison between the...

Job SummaryWe are seeking an experienced Clinical Care Management Specialist to join our Complex Care team. The successful candidate will be responsible for providing intermediate or high-intensity care management services to members with complex needs.Responsibilities:Work directly with members, natural supports, and providers in the community to develop...

Job Description:As a Clinical Care Manager (CCM) Specialist - Complex Care at Community Behavioral Health, you will be part of a specialized team responsible for providing intermediate or high intensity care management. Your primary focus will be on working collaboratively and directly with members and providers to ensure effective, holistic, member-centric...

About the PositionWe are looking for a detail-oriented Clinical Care Manager to join our team. As a Clinical Care Manager, you will be responsible for managing ABA-Designated Providers within the IBHS Level of Care, consulting to teams managing other Levels of Care, as needed or assigned.Key FunctionsManage ABA-Designated Providers within the IBHS Level of...

Job OverviewNorthern Children's Services is a leading organization dedicated to supporting the healthy development of children and youth, while stabilizing their families to build stronger communities. We are seeking an experienced Clinical Services Manager to join our team.This role will provide clinical leadership to our Intensive Behavioral Health...

ResponsibilitiesThe Clinical Dietitian will be responsible for planning, organizing, developing, and directing the nutritional care of residents in accordance with current federal, state, and local standards, guidelines, and regulations. This will involve working effectively with other departments to ensure compliance and providing administrative authority,...