- Highmark Health (Harrisburg, PA)
- …current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and ... RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to...includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well… more
- Pfizer (Collegeville, PA)
- …area supported. + The role will serve as a key interface across Oncology Medical Affairs, the Chief Medical Office, the International Medical Affairs ... as well as with enabling functions across the enterprise as needed (eg, Medical Evidence Generation, digital, finance, legal, compliance, etc). + The Director will… more
- CVS Health (Pittsburgh, PA)
- …in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The Medical ... including post-graduate direct patient care experience specifically. Expands Aetna's medical management programs to address member needs across the continuum… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements… more
- CVS Health (Harrisburg, PA)
- …License without encumbrances or the ability to obtain a NJ License. In the Medical Director role you will provide oversight for medical policy implementation. ... in the development, implementation, and evaluation of clinical / medical programs and expand Aetna's medical management...will be considered for employment in accordance with all federal , state and local laws. We are an equal… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by… more
- UPMC (Enola, PA)
- Join our team of Life Changers! UPMC is hiring a Full-Time, Medical Assistant for various levels of experience to support the primary office in Harrisburg. Position ... provider guidelines. + Relay instructions to patients/families. + Send/receive patient medical records in accordance with Health Insurance. + Portability and… more
- UPMC (Pittsburgh, PA)
- UPMC Margolis Rheumatology is hiring a full-time Medical Assistant to join their team on UPMC St. Margaret's campus! In this position, you will work Monday-Friday ... will be placed in the appropriate job title and salary from the Medical Assistant Career Ladder, based on their individual experience and education. The compensation… more
- Highmark Health (Pittsburgh, PA)
- …qualify** **GENERAL OVERVIEW:** As a member of the health care team, the Medical Assistant Lead provides clinical oversight and provides guidance at large multi-site ... Oversees the remaining and onboarding process for newly hired medical assistants. Educates Medical Assistants on new...includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well… more
- UPMC (Pittsburgh, PA)
- UPMC Community Medicine Incorporated is hiring a full-time Medical Assistant to support Northern Gastroenterology Associates located at 5500 Brooktree Road STE 201 ... Babcock Boulevard Pittsburgh PA 15237. See what being a Medical Assistant can do for UPMC and what UPMC...Portability and Accountability Act (HIPAA) and other state and federal regulations. + Prepare patient rooms, set up instruments… more
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