Processes acute and post-acute inpatient medical or behavioral health and select intensive outpatient higher level of care requests through review of the submitted request and applicable clinical records
Collaborates with UM department staff, including Clinical Support Specialists and Medical Directors to make a final determination, and with Care Management staff on discharge planning and transition of care activities.
Identifies and refers members with complex needs to the appropriate population health and/or care management program.
Capital Blue Cross promises to go the extra mile for our team and our community. Our employees consistently vote us one of the “Best Places to Work in PA, and we foster a flexible environment where your health and wellbeing are prioritized.
Practice active listening, empathy, and solution-focused approaches to collaboratively engage with patients seeking support.
Prioritize effectively across multiple channels and follow care team protocols using good judgment to identify barriers to care.
Interact and problem-solve with multi-disciplinary teams to ensure a safe and excellent patient experience and resolve issues related to prescriptions.
Ophelia is a venture-backed healthcare startup that helps individuals with OUD by providing FDA-approved medication and clinical care through a telehealth platform. They are a team of physicians, scientists, entrepreneurs, researchers and White House advisors working to re-imagine and re-build OUD treatment in America.
Conduct comprehensive assessments of students' speech, language, and communication abilities.
Develop individualized therapy plans and goals based on assessment results and students' needs.
Provide direct therapy services to students, targeting areas such as articulation, phonology, language comprehension, fluency, and pragmatic skills.
E-Therapy delivers clinical solutions to PreK-12 schools through an advanced, technology-driven platform. They connect schools with a network of qualified, licensed clinicians, offering accessible and impactful services to empower schools, sizes undisclosed but seem passionate.
Monitor and own the progress of clinical studies at investigative sites.
Coordinate all necessary activities required to set up and monitor a study.
Ensure that clinical studies are conducted, recorded, and reported per protocol, SOPs, ICH-GCP, and all applicable regulations and standards.
Precision for Medicine integrates clinical trial execution with deep scientific knowledge, laboratory expertise and advanced data sciences to improve the speed, cost and success rate of bringing life-changing therapies to patients. They have a strong focus on Oncology and Rare Disease and boast extremely high CRA retention rates compared to industry averages.
Stay current with guidelines for children aged 0 to 12 in the LATAM region.
Use your clinical experience to engage in discussions and educate others.
Participate in quality assurance initiatives and audits to ensure safety, compliance, and high standards.
Carrot is a global fertility and family care platform that supports members through life's memorable moments. They are trusted by leading employers and health plans, offering localized support in over 170 countries and 25 languages.
Work directly with clinicians to adopt technology and improve patient outcomes.
Coach clinicians and staff on best practices for Limber’s RTM platform.
Build relationships, identify barriers, and drive improvements in RTM utilization.
Limber Health transforms musculoskeletal care delivery, blending in-clinic treatment with digital support. Trusted by top providers and health plans, Limber redefines modern rehab by making quality care accessible and effective.
Maintain competency within the Legal Nurse Consulting field.
Exhibit writing skills through the production of professional reports.
Exhibit exceptional organizational and time management skills.
J.S. Held is a global consulting firm that combines technical, scientific, financial, and strategic expertise to advise clients seeking to realize value and mitigate risk. They have experienced rapid growth and offer the opportunity to work in a highly entrepreneurial environment.
Answers calls and route all incoming correspondence to appropriate staff.
Maintains up to date patient health records in the Electronic Medical Record system and Vynca data systems.
Coordinates transportation for patient medical appointments with contracted transportation companies and payers.
Vynca is passionate about transforming care for individuals with complex needs and is focused on providing comprehensive care for more quality days at home.