• Utilization Management

    Penn State Health (Hershey, PA)
    …status, and family medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** Utilization Management Specialist - Utilization ... responsible for maintaining compliance with the CMS Conditions of Participation for Utilization Management . MINIMUM QUALIFICATIONS: * Bachelors Degree in Nursing… more
    Penn State Health (05/13/25)
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  • Specialist (Part-time) - Varied Shifts…

    Penn State Health (Hershey, PA)
    …###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) Penn State Health is seeking a dedicated ** Utilization Management Specialist ** to join our ... SEIU Healthcare Pennsylvania **Position** Specialist (Part-time) - VARIED SHIFTS - Utilization Management **Location** US:PA: Hershey | Nursing | Part Time… more
    Penn State Health (04/17/25)
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  • Utilization Management

    Penn Medicine (Lancaster, PA)
    …each day. Are you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical ... insurance benefit structures and related legal medical issues. + Knowledge of utilization management and quality improvement processes. + Experience working… more
    Penn Medicine (05/01/25)
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  • Drug & Alcohol Case Management

    Commonwealth of Pennsylvania (PA)
    Drug & Alcohol Case Management Specialist (Local Government) - Luzerne-Wyoming County D&A Print ... (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4892947) Apply  Drug & Alcohol Case Management Specialist (Local Government) - Luzerne-Wyoming County… more
    Commonwealth of Pennsylvania (05/23/25)
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  • Clinical Pharmacy Specialist - Prior…

    UPMC (Pittsburgh, PA)
    …of Prior Authorization, Step Therapy, Quantity Limit, and all other pharmacy utilization management requests in accordance with quality, timeliness, and ... UPMC Health Plan is hiring a full-time Clinical Pharmacy Specialist to support the Prior Authorization Team within the...efficiency standards. + Critically review pharmacy utilization management requests for approval/denial against standard… more
    UPMC (05/21/25)
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  • Supervisor Child Life Specialist

    Penn Medicine (Lancaster, PA)
    …(CCLS) with required Education and Experience.** The Supervisor Child Life Specialist (CLS) demonstrates competence in supporting pediatric patients and family ... evaluation. Serve as the face of the Child Life Specialist team to providers, staff, and patients. Supervise and...job duties as outlined below (approximately 40%). Human Resource Management : (30%) * In collaboration with Director, assists with… more
    Penn Medicine (05/08/25)
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  • Denials Management Specialist (RN…

    St. Luke's University Health Network (Allentown, PA)
    …serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical ... setting required. + Prefer minimum of 2-5 years' experience in case management and/or utilization management . + Prefer financial experience related to appeal… more
    St. Luke's University Health Network (05/14/25)
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  • Logistics Management Specialist

    US Army Reserve Command (Horsham, PA)
    …the Army Reserve, visit http://www.goarmy.com/reserve/jobs.html Responsibilities Serve as a Logistics Management Specialist in an Army Reserve Brigade or ... Executive Order (EO) 12721 Interagency Career Transition Assistance Plan Land Management Workforce Flexibility Act Military Spouses, under Executive Order (EO) 13473… more
    US Army Reserve Command (05/17/25)
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  • Sr. Specialist , Account Management

    Cardinal Health (Harrisburg, PA)
    …urology community members and solutions to our industry partners. The _Sr. Specialist , Account Management (UroGPO Member Development)_ is responsible for ... Member Profiles, and overall success of membership network with utilization and optimization of Salesforce keeping up to date...1+ years of Sales and Marketing experience (or account management in a customer facing capacity), highly preferred. +… more
    Cardinal Health (05/09/25)
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  • Juvenile Justice Specialist Trainee, North…

    Commonwealth of Pennsylvania (PA)
    Juvenile Justice Specialist Trainee, North Central Secure Treatment Unit, Montour County Print ... (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4940426) Apply  Juvenile Justice Specialist Trainee, North Central Secure Treatment Unit, Montour County… more
    Commonwealth of Pennsylvania (05/19/25)
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  • Clinical Pharmacy Specialist (Full time,…

    Penn Medicine (Lancaster, PA)
    …Are you living your life's work? Job Title: Clinical Pharmacy Specialist (FT/Days) Location: Lancaster, PA Hours: 08:00am-4:30pm POSITION SUMMARY: Provide direct ... development and implementation of clinical programs, P&T activities, formulary management , etc. ESSENTIAL FUNCTIONS:Qualified individuals must have the ability (with… more
    Penn Medicine (04/22/25)
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  • TRACK Software Specialist

    Shell (Monaca, PA)
    …working with a newly constructed world-class asset. As a TRACK Software Specialist , you will work within the Shell Polymers Monaca Maintenance, Turnaround and ... accurate recording and reporting of business transactions. **Accountabilities:** + Management and set-up of user accounts, password resets, profile permissions,… more
    Shell (05/24/25)
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  • IDD/A Program Specialist

    Achieving True Self (Irwin, PA)
    Intellectual/Developmental Disabilities and Autism Program Specialist Achieving True Self is expanding, and we have an INCREDIBLE opportunity for an exceptional ... IDD/A Program Specialist and we are looking to our current team...and ensure safety and risk mitigation, complete monthly incident management review, complete 3 month trend analysis for quarter… more
    Achieving True Self (04/10/25)
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  • Pharmacist Clinical Specialist -Oncology

    St. Luke's University Health Network (Bethlehem, PA)
    …the hematology/oncology providers, and infusion centers to monitor chemotherapeutic utilization , supportive drug therapy utilization , adverse drug reactions, ... treatment of malignancy, safe handling of hazardous medication, and drug utilization . Mentors pharmacists, pharmacy residents, and students. Interacts with health… more
    St. Luke's University Health Network (04/12/25)
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  • CQVA Specialist - Supply Chain Clinical…

    Penn State Health (Hershey, PA)
    …trends. + Maintain best practice for CQVA program. + Expert in change management . + Lead and support change initiatives while prioritizing stakeholder needs to ... + Strategically expands the CQVA framework to support effective implementation, utilization , and continuous improvement. + Maintain and grow the CQVA process… more
    Penn State Health (04/17/25)
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  • Certified Peer Specialist , Victory…

    St. Luke's University Health Network (Lehighton, PA)
    …Lehighton Campus, 211 North 12th Street, Lehighton, PA 18235 The Veteran Certified Peer Specialist has the lived experience of service in the armed forces along with ... with Veterans to facilitate their recovery and community integration through utilization of their own personal life experience and first-hand recovery knowledge.… more
    St. Luke's University Health Network (05/04/25)
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  • Software Support Specialist

    Carbon Lehigh Intermediate Unit 21 (Schnecksville, PA)
    Software Support Specialist JobID: 1513 + Position Type: PROFESSIONAL 12 MONTH/ SOFTWARE SUPPORT SPECIALIST + Date Posted: 12/16/2024 + Location: Schnecksville, ... special education programs, ensuring data integrity and generating actionable insights. The specialist will also serve as the primary resource for training and… more
    Carbon Lehigh Intermediate Unit 21 (03/17/25)
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  • Recovery Specialist - Substance Use…

    St. Luke's University Health Network (Sellersville, PA)
    …serve, regardless of a patient's ability to pay for health care. The Recovery Specialist has experience with behavioral health services and is willing to use and ... their family members to provide expertise around the recovery process, symptom management , and the persistence required by clients/families to have a recovery… more
    St. Luke's University Health Network (05/20/25)
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  • Recovery Specialist - Substance Use…

    St. Luke's University Health Network (Sellersville, PA)
    …serve, regardless of a patient's ability to pay for health care. The Recovery Specialist has experience with behavioral health services and is willing to use and ... their family members to provide expertise around the recovery process, symptom management , and the persistence required by clients/families to have a recovery… more
    St. Luke's University Health Network (05/01/25)
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  • DRG Specialist

    UPMC (Pittsburgh, PA)
    UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position ... documentation within the medical record to ensure that all patient resource utilization , principal diagnosis, secondary diagnoses, and PCS procedures have been coded… more
    UPMC (05/21/25)
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