- CVS Health (Harrisburg, PA)
- …part of a growing business segment, selling our competitive portfolio of Medicare products. Upon acquisition the Field Sales Representative will own the member ... Continued Education (CE's) + Product Certification + Required Security and Compliance + Client/Carrier Certifications + Any required CMS Certifications **Required… more
- Humana (Harrisburg, PA)
- … compliance on this complex and expanding areas. In addition, this role supports compliance of Medicare bid filings and allows you to see the overall end ... us put health first** The Lead Actuary, Risk and Compliance is responsible for the overall management and oversight...to end bid process at a leading Medicare Advantage organization. This is a great role for… 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 ... reviewing home health, SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether… more
- NASCO (Harrisburg, PA)
- **Overview** The Senior Corporate Counsel, Compliance & Commercial operates under general direction and is responsible for providing legal and regulatory guidance to ... and drafts complex commercial transactions, including technology agreements, and provides compliance guidance and support throughout the organization to ensure our… more
- Fresenius Medical Center (Harrisburg, 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
- St. Luke's University Health Network (Allentown, PA)
- …operations, billing compliance , and financial reporting requirements + Ensure compliance with all applicable Federal regulations and institutional policies ... with 7+ years of direct experience in research finance, grants management, or compliance in an academic medical center, hospital network, or research institution… 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
- Humana (Harrisburg, PA)
- …clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Robert Half Accountemps (Doylestown, PA)
- Description We are looking for a motivated and detail-oriented Medical Accounts Receivable Specialist to join our team, working Monday through Friday from 8:00 AM to ... part in maintaining the financial health of our organization by handling Medicare billing, patient accounts, and insurance claims with precision and efficiency.… more
- Highmark Health (Harrisburg, PA)
- …Description :** **JOB SUMMARY** This job assures that members with complex medical and/or psychosocial needs have access to high quality, cost-effective health care. ... Physician Advisors and other interdepartmental contacts. + Maintain knowledge of Medical Terminology and Medical Diagnostic Categories/Disease States + Educate… more