This is truly an extraordinary time to join the Lehigh Valley Health Network. LVHN is one of the nation's most advanced health networks, offering comprehensive care in 95 clinical specialties. Love where you work!! To learn more, please send your CV to Carissa.Abel@lvhn.org.

Overview:

Provides consultation on the level of care, utilization of resources, discharge issues and options, timeliness and appropriateness of care, payment denials, and other issues. Consults with physicians to improve the efficiency of care delivery, transitions of care, and clinical documentation.

Job Qualifications:

• Reviews clinical information on patients to determine the appropriate status.
• Performs Peer to Peer (P2P) reviews to attempt to overturn denials from Payors.
• Writes backend appeals to overturn denials from Payors.
• Knows and understands the process approved by the Medical Director to determine status.
• Consults with Case Managers to aid in Discharge Planning.
• Consults with Providers to aid in determining appropriate level of care for patients.
• Expedites discharges to complete work-up out of hospital.

Required:

License:

• A current PA Medical License or the ability to obtain one upon hire.
• Must be Board Eligible or Board Certified.

Experience:

• 5 years delivering direct patient care in a hospital setting.

Knowledge, Skills, and Abilities:

• Demonstrates well developed problem solving, communication, leadership, and interpersonal skills.

Benefits & Perks:

• VIRTUAL! Attractive Work Schedule
• Competitive compensation with a superb benefits package
• Low-cost health insurance for employees and their families.
• Top-tier retirement programs.
• Public Service Loan Forgiveness Assistance Program.

Influenza vaccination and COVID-19 Vaccination is required for all colleagues unless medically contraindicated or due to a bona fide religious belief or practice. Applicants possessing a medical marijuana card will not be considered for safety sensitive positions.

EEO