- Highmark Health (Harrisburg, PA)
- …internal clinical and value-based evaluation committees that drive formulary and utilization management functions. + Participate in product specific Pharmacy and ... Therapeutics Committees and Drug Utilization Review (DUR) Committees as necessary or contractually required....position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Harrisburg, PA)
- …agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees. ... designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret… more
- WellSpan Health (Lewisburg, PA)
- …providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. ... with award-winning care. One of nine premier hospitals in the WellSpan Health System, WellSpan Evangelical Community Hospital's 131-bed facility provides a community… more
- University of Pennsylvania (Philadelphia, PA)
- …Life, and Flexible Spending Accounts : Penn offers comprehensive medical, prescription, behavioral health , dental, vision, and life insurance benefits to protect ... professional development opportunities, supportive work and family benefits, a wealth of health and wellness programs and resources, and much more. Posted Job Title… more
- UPMC (Pittsburgh, PA)
- …and modifies the care plan with member, caregivers, PCP, specialists, community resources, behavioral health contractor, and other health plan and system ... interested in the opportunity to work from home? UPMC Health Plan is looking for you! We are hiring...members and their caregivers and providers. Identifies members' medical, behavioral , and social needs and barriers to care. Develops… more
- Penn Medicine (Lancaster, PA)
- …and coordinating care across various services, including hospital, specialty, and community health resources. The ideal candidate will be a Social Worker with strong ... visits, collaboration with multidisciplinary teams, and proactive outreach to improve health outcomes. Experience with home visits and knowledge of Lancaster County… more
- AmeriHealth Caritas (Philadelphia, PA)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay… more
- Highmark Health (Pittsburgh, PA)
- …Description :** **JOB SUMMARY** This job serves as a liaison between Highmark Health Plan and Highmark Home and Community Services (HCS). Must ensure HCS compliance ... to contracted Service-Level-Agreements. The incumbent must have an understanding of health plan needs to ensure HCS solutions meet the need of all Highmark service… more
- Highmark Health (Monroeville, PA)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This position is responsible for the strategic implementation of supply chain ... control multiple complex supply chain activities within acute and ambulatory health care institutions. Provides supervision to the various Material Management teams,… more
- Highmark Health (Pittsburgh, PA)
- **Company :** Allegheny Health Network **Job Description :** **JOB SUMMARY** This position is accountable and responsible for practice as a licensed registered nurse ... inpatient bedside nurse, patient/family, and other members of the health care team. (10%) + Prioritizes care based on...**Required** + 7 years of inpatient nursing experience including utilization of the Electronic Medical Record + Act 34… more