- CenterWell (Harrisburg, PA)
- …collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria ... + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF,… more
- CenterWell (Harrisburg, PA)
- …quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity ... the Advisor will collaborate across functions (particularly Data, Technology, Analytics, Medical Economics, and Finance) to optimize strategies that address current… more
- BAYADA Home Health Care (Boyertown, PA)
- …and appropriateness of all services provided by your staff to ensure compliance and client satisfaction while ensuring adequate staff education, training and ... Degree OR MHA Degree + Management experience within a Medicare Certified Home Care Agency + Demonstrate record of...Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with… more
- CenterWell (Harrisburg, PA)
- …Lead and drive strategic sales enablement initiatives focused on Original Medicare , veterans' outreach, and innovation pilots, ensuring alignment and optimizing ... initiatives. + Strong understanding of the senior healthcare industry, particularly Medicare Advantage and value-based care. + Must be a strategic thinker… more
- WellSpan Health (York, PA)
- …and some evenings **General Summary** Coordinates clinical research activities and compliance to study requirements, and patient and staff considerations relative to ... collection of research data for patients in clinical trials. Assists the medical investigators in achieving the objectives of clinical research studies and supports… more
- Penn Medicine (Philadelphia, PA)
- …currently performed in the section Performs teaching functions with residents/fellows, Medical Laboratory Science and other students.Regulatory Compliance : Works ... leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across… more
- Penn Medicine (Philadelphia, PA)
- …performed in the section + Performs teaching functions with residents/fellows, Medical Laboratory Science and other students. **Regulatory Compliance ** : ... leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across… more
- UPMC (Pittsburgh, PA)
- …controlled substances. Assure that all such drugs are stored and dispensed in compliance with Federal , State, and Department Regulations. + General: Procure and ... ordering, receiving, and filling, and maintain appropriate inventory documentation in compliance with Federal , State, and Department Regulations. +… more
- WellSpan Health (York, PA)
- …including managers, specialists and coordinators. + Collaborates with executive leadership, medical staff services, compliance , legal, payer contracting and HR ... to ensure cross-functional alignment. + Ensures compliance with all applicable state and federal regulations, payer requirements and accrediting bodies. Oversees… more
- Humana (Harrisburg, PA)
- …and representing Humana IT with internal business partners along with State and Federal regulators. The Lead contributes to RFP responses to ensure they are accurate ... discuss IT priorities, new requests, and collaborate with Market Operations and Compliance teams. Facilitate and communicate with state agencies on outages, impacts,… more