- Highmark Health (Harrisburg, PA)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...management process are consistent with community standards of care . + Participate as a member of the CMDM… more
- Geisinger (Danville, PA)
- …for comprehensive oversight and accountability for pharmacy practice, comprehensive medication management , medication use process, and transitions of care for ... partners to develop processes or programs to address identified issues with medication utilization and overall patient care . + Provides oversight and contributes… more
- Highmark Health (Pittsburgh, PA)
- …portfolio of AI-powered products, including a core administrative platform, modular utilization and care management solutions, patient-focused digital ... **JOB SUMMARY** We are seeking a highly experienced and results-oriented Director , Sales Solution Architect for enGen healthcare technology business. This critical… more
- Verint Systems, Inc. (Harrisburg, PA)
- …enrollment processes, including obtaining and analyzing benchmark data and utilization data, identifying trends, preparing recommendations with impact assessments ... a culture of health with an emphasis on preventive care . + Monitor benefits programs to ensure compliance with...four pillars. + Responsible for all aspects of leave management , tuition reimbursement, paid time off, annual holiday schedules… more
- WellSpan Health (York, PA)
- …team. **Qualifications** **Minimum Education:** + Bachelors Degree in Health Care Administration, Business Management , or related field required. ... mergers, and clinical integration efforts. + Leads optimalization and utilization of credentialing/enrollment software systems to support scalability and accuracy.… more
- Kyndryl (Harrisburg, PA)
- …industry experience is a strong plus, especially in payer/provider operations and care management workflows. **Preferred Qualifications: ** + 15+ years' ... experience in leading healthcare-focused journey redesign from eligibility verification to care management . + Align contact center transformation with healthcare… more
- UPMC (Somerset, PA)
- **Purpose:** This position is accountable for achieving quality patient care through appropriate leadership and utilization of human and fiscal resources in ... that are patient centered and within the framework of Relationship Based Care . Participates in professional organizations to enhance personal growth and facilitate… more
- Globus Medical, Inc. (Eagleville, PA)
- …tangible musculoskeletal solutions. We are constantly in pursuit of better patient care and understand that speed is critical because life cannot wait. **Position ... The Manufacturing Site Leader is responsible for the creation, implementation, and management of the new Branch Specialty Devices Operation. This effort includes,… more
- Travelers Insurance Company (Harrisburg, PA)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... **Who Are We?** Taking care of our customers, our communities and each...the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work… more
- Geisinger (Danville, PA)
- Job Summary Provides accountable leadership, administration, and management of system-wide programs for well-being, provider burnout reduction and professionalism. ... + Develops and oversees the implementation of a comprehensive library of utilization and outcomes metrics related to well-being and professionalism. + Maintains… more