- Evolent (Harrisburg, PA)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology to ... innovation, continuous improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple opportunities for a… more
- Merck (Harrisburg, PA)
- **Job Description** **Position Responsibilities** + The Regional Medical Scientific Director (RMSD) is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and ... communication, and networking skills + A thorough comprehension of FDA, OIG, HIPAA , and other ethical guidelines, laws, and regulations relevant to the… more
- Highmark Health (Harrisburg, PA)
- …the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In ... for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure… more
- The Cigna Group (Philadelphia, PA)
- We are seeking a strategic and experienced Director of Enterprise Incident Response. This role will manage a team of privacy incident investigators and compliance ... standards, and escalation procedures, in alignment with regulatory requirements, including HIPAA , state and federal privacy laws, data use regulations, and breach… more
- NASCO (Harrisburg, PA)
- …strategy, platforms and patterns, AI/ML governance, and US healthcare payer regulatory compliance (eg, HIPAA , HITRUST, CMS). This person leads Data Architects, ... **Overview** Under general direction, the Director of Data and AI Architecture will drive...including ethics, model management and explainability, bias mitigation, and compliance with evolving regulations + Reviews and gains approval… more
- Humana (Harrisburg, PA)
- …Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Travel: While this is a remote position, occasional travel to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Sumitomo Pharma (Harrisburg, PA)
- …seeking a highly motivated and experienced individual for the position of ** Director , Patient Services** . Primary responsibilities include leading and developing a ... strategic framework for patient support services, aligned with brand imperatives. The Director has oversight of patient services operations and manages within the… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …to all company policies, procedures, and training related to information security and compliance programs, including SOC1, SOC2, PCI, and HIPAA . + Maintain ... director %2c-program-management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-1834382591) Share on News Feed LocationUS-PA-Pittsburgh ID2025-3174 Category Customer Service Position Type Full Time … more
- Humana (Harrisburg, PA)
- …Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information This is a remote position. **Scheduled weekly hours** **:** ... our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals.… more
- Humana (Harrisburg, PA)
- …+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information This is a remote position Travel: While this is a ... our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The… more