- Humana (Harrisburg, PA)
- …a part of 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. The Corporate Medical Director works on problems of diverse scope and...necessity of services provided by other healthcare professionals in compliance with coverage policies, procedures, and performance standards. CMD… more
- Public Consulting Group (Harrisburg, PA)
- …learn more, visit www.publicconsultinggroup.com . Duties & Responsibilities . Prepare Medicare and/or Medicaid cost reports for ambulance providers. . Reconcile ... general ledger and accounting assistance to financial staff. . Ensure compliance with accounting principles and procedures. . Recommend accounting process… more
- Humana (Philadelphia, PA)
- …exceed $123K depending on experience and location. Are you passionate about the Medicare population, looking for an opportunity to work in sales with the ability ... as well as, visiting prospects in their homes. Our ** Medicare Sales Field Agents** sell individual health plan products...could exceed 123k depending on experience and location. + Medical , Dental, Vision and a variety of other supplemental… more
- CVS Health (Blue Bell, PA)
- …exciting and growing government services pharmacy business. The primary focus is the Medicare Part D product strategy and pricing of MAPD, SNP and PDP Products. ... This role will focus on developing health care solutions for Medicare Part D members. The colleague provides actuarial support to ensure business strategy achieve… more
- CVS Health (Harrisburg, PA)
- …lifecycle management of Aetna's integrated products (HIDE/FIDE) that serve Medicare Advantage populations, including Dual-Eligible Special Needs Plans (D-SNP). This ... care objectives. Working cross-functionally with Duals Center of Excellence, clinical, compliance , analytics and network teams, the Senior Manager drives innovation… more
- Humana (Harrisburg, PA)
- …clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage ... authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources which...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Humana (Harrisburg, PA)
- …ensuring compliance with governmental requirements for clinics across both federal and state requirements. The work assignments involve moderately complex to ... and procedures. Research compliance issues and recommends changes that assure compliance with federal and/or state requirements related to Provider Clinic… more
- Humana (Harrisburg, PA)
- **Become 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 ... clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage… more
- Humana (Harrisburg, PA)
- …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Fresenius Medical Center (Wyomissing, PA)
- …**Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans** ... core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and company policy requirements PRINCIPAL… more
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