- Humana (Harrisburg, PA)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits +… more
- Evolent (Harrisburg, PA)
- …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology… more
- Evolent (Harrisburg, PA)
- …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Evolent (Harrisburg, PA)
- …Computer Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Evolent (Harrisburg, PA)
- …Computer Proficiency . Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Evolent (Harrisburg, PA)
- …Computer Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- Humana (Harrisburg, PA)
- …associates have met all training requirements for company, quality, and regulatory compliance . + Analyzes course evaluations in order to judge the effectiveness of ... to learn different processes + Bilingual in English/Spanish + Experience with Medicare + Healthcare experience + CGX experience **Additional Information** + **WAH**… more
- CenterWell (Harrisburg, PA)
- …an in-depth understanding of the healthcare industry, including value-based care, Medicare , population health, Accountable Care Organizations (ACOs), medical ... with healthcare industry including value-based care, health plans, health systems, Medicare , accountable care, population health, medical group management /… more
- CenterWell (Harrisburg, PA)
- …a Medicare certified home health agency. + A thorough knowledge of federal regulations and Medicare requirements is required along with analytical skills to ... + Responsible for constructing response to denials and appeals, utilizing any federal guidelines or local coverage determination guidelines that are applicable to… more
- Highmark Health (Blue Bell, PA)
- …for risk revenue management for all government program products (commercial ACA, Medicare , and Medicaid). Establishes the strategic direction for the Risk Revenue ... comprehensive and accurate diagnosis coding for risk adjusted government programs ( Medicare Advantage, ACA business, and Medicaid). Also work with Care Management… more