Clinical Reviewer

Acentra Health is a leading provider of health care services, and we are seeking a skilled Clinical Reviewer to join our team.As a Clinical Reviewer, you will play a critical role in ensuring the quality and integrity of our health care services. Your primary responsibility will be to review medical records and determine medical necessity and appropriateness...

About Acentra HealthAcentra Health is a leading provider of healthcare solutions, empowering better health outcomes through technology, services, and clinical expertise.Job SummaryWe are seeking a skilled Clinical Reviewer to join our team. As a Clinical Reviewer, you will utilize your clinical expertise to review medical records against appropriate...

Acentra Health is seeking a skilled Clinical Reviewer to join our team. As a Clinical Reviewer, you will play a critical role in ensuring the quality and accuracy of medical records. Your expertise will be utilized to review medical records against established criteria, utilizing your clinical knowledge and critical thinking skills to determine medical...

Care Manager Job DescriptionThe Care Manager at UPMC is responsible for coordinating the clinical and financial plan for patients. This involves performing overall utilization management, resource management, discharge planning, and post-acute care referrals and authorizations. The Care Manager works with a multi-disciplinary team in resource management,...

Job Summary:UPMC is seeking a skilled Clinical Utilization Manager to coordinate clinical and financial plans for patients. This is a full-time, day shift position with rotating weekend and holiday schedule.Main Responsibilities:• Reviews medical records daily to ensure patients continue to meet Level of Care (LOC) requirements and chart documentation...

About the Role:CVS Health is seeking a skilled Utilization Management Nurse Consultant to join our team. As a Utilization Management Nurse Consultant, you will play a critical role in coordinating, documenting, and communicating all aspects of the utilization/benefit management program.Key Responsibilities:Utilize clinical skills to coordinate, document, and...

Penn State Health: A Leader in HealthcarePenn State Health is a multi-hospital health system serving patients and communities across 29 counties of Pennsylvania. Our mission is to improve health through patient care, research, education, and community outreach.About the RoleWe are seeking a highly skilled Registered Nurse to join our team as a Clinical Staff...

Job SummaryCVS Health is seeking a highly skilled Pharmacy Technician to join our team in a non-clinical diversion role. As a Pharmacy Technician - Non-Clinical Diverts, you will play a critical role in ensuring the accuracy and integrity of prescription orders, while also contributing to the prevention of diversion and misuse of medications.Key...

Job Summary:UPMC is seeking a Part-time Care Manager to coordinate the clinical and financial plan for patients. This role involves overall utilization management, resource management, discharge planning, and post-acute care referrals and authorizations.Responsibilities:Reviews medical records daily to ensure patients continue to meet LOC requirements and...

Job SummaryAs a Pharmacist at Insight Global, you will play a vital role in assisting customers with their healthcare needs by filling prescriptions, providing clinical services, and delivering exceptional customer service. You will also supervise pharmacy associates and assume management responsibility as needed.Key ResponsibilitiesEnsure the accuracy and...

Job SummaryThis is an exciting opportunity for Pharmacy Technicians to excel in a complex, team-oriented environment while developing and strengthening technical skills and pharmacology knowledge. The Non-Clinical Divert technician is responsible for screening orders, specializing in research, review and entry of prescription overrides. Basic knowledge and...

Job SummaryClinical Pharmacist Specialists play a vital role in patient care teams, focusing on safe and effective medication management for specialized patient populations.They provide direct patient-centered care, collaborate with interdisciplinary teams, and ensure clinical pharmacy services are integrated into the care process.Key responsibilities...

Acentra Health seeks a skilled RN Sanction Specialist to oversee the CMS Sanction process and ensure compliance with EMTALA regulations.Key Responsibilities:Maintain lines of communication between BFCC QIO and healthcare providersProduce written Initial and Final Sanction Notices and EMTALA communicationsMaintain case files with supporting...

Penn State Health is seeking a skilled Registered Nurse to join our team in Harrisburg, Pennsylvania.Job Summary:The Registered Nurse Clinical Staff Leader will be responsible for ensuring the delivery of high-quality patient care and optimal patient outcomes in our Behavioral Health Inpatient Acute Care unit.Responsibilities:Provide clinical patient care...

As a Pharmacist at UPMC, you will play a critical role in ensuring the provision of cost-effective pharmacotherapy that contributes to optimal patient outcomes. You will provide experiential education for present and future healthcare practitioners and support drug-related research.Key Responsibilities:Interpret and evaluate physician orders to prepare,...

pbAbouttheRole/b/ppWeareseekingaskilledPharmacyTechniciantojoinourteaminanon-clinicaldivertsrole.AsaPharmacyTechnician,youwillberesponsibleforscreeningorders,specializinginresearch,review,andentryofprescriptionoverrides.Thisisanexcitingopportunitytodevelopandstrengthentechnicalskillsandpharmacologyknowledgewhileworkingfromhome./ppbKeyResponsibilities/b/pulli...

Job Title: Clinical PharmacistWe are seeking a skilled Clinical Pharmacist to join our team at ALOIS Healthcare. As a Clinical Pharmacist, you will be responsible for reviewing prescriptions, compounding and dispensing medications, and providing exceptional patient care in a retail environment.Key Responsibilities:Review and verify prescriptions for accuracy...

At CVS Health, we're committed to delivering enhanced human-centric healthcare for a rapidly changing world. As a Utilization Management Nurse Consultant, you'll play a critical role in transforming our culture and accelerating our ability to innovate and deliver solutions that make healthcare more personal, convenient, and affordable.Job SummaryThis is a...

As a key member of the University of Pittsburgh Medical Center team, the Veteran Care Representative plays a vital role in managing incoming calls, in-basket messages, and emails from clinics, patients, and VA Medical Centers in a timely and efficient manner. This includes receiving referrals from VA Medical Centers and conducting thorough reviews of...

Job SummaryWe are seeking a highly skilled Nurse Practitioner/Physician Assistant to join our team at Connections Health Solutions. As a crisis mental health specialist, you will provide medical/clinical services to individuals in crisis, including intervention, psychiatric evaluation and assessment, differential diagnosis, treatment planning, medication...