- Highmark Health (Pittsburgh, PA)
- …Committee review. + Assist in the development and implementation of utilization management programs including but not limited to: prior authorization, dose and ... duration edits, quantity limits, step-care edits, generic sampling medical policy review and development, member facing outreach initiatives + Develop and implement… more
- Highmark Health (Pittsburgh, PA)
- …reports to support capitation payment methods. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities including, but not limited to: involved in hiring ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the… more
- CVS Health (Monroeville, PA)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...cycle leadership team and staff through effective recruitment, talent management , creation of a collaborative results-oriented culture, and a… more
- WellSpan Health (Chambersburg, PA)
- …acting as the primary contact for the center interacting with building management . + Interact with administrative offices of the organization regarding the selection ... and reviews quality assurance information relating to practice and patient care issues . + Manages the daily business operations including purchasing and resolves any… more
- Highmark Health (Harrisburg, PA)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job will manage small scale projects and enhancement packages with mentorship and leadership ... from more senior Delivery Owners. The incumbent provides project management leadership and facilitates the delivery of system changes...lists and take action to mitigate risks and address issues . Ensure that all stakeholders have full and timely… more
- Highmark Health (Camp Hill, PA)
- … Health ) on key risk and compliance related activities, issues , and remediation, promoting effective relationships.Manages teams conducting internal mock audits ... the Blue Cross Blue Shield Association (BCBSA), accreditation bodies, executive management , plan partners, group customers, and employee level performance. The… more
- WellSpan Health (Chambersburg, PA)
- …+ Innovation: Breakthrough Thinking, Knowledge-Building/Sharing, Coaching/Empowering, System Vision & Management \#LI-PG1 WellSpan Health 's vision is to ... Chambersburg Hospital, we work together to provide our neighbors with important health -related programs focused on disease prevention and management , early… more
- Veterans Affairs, Veterans Health Administration (Pittsburgh, PA)
- …responsibility for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Administers ... the immediate practice setting. Improves Veteran/patient driven care by resolving experience issues such as coordination of care, timeliness or process issues ,… more
- Highmark Health (Camp Hill, PA)
- …robust risk management processes to ensure compliance and mitigate potential issues across all government programs, with a particular focus on the complexities ... competitor analysis, proposal development, contract negotiation, and ongoing contract management . Actively monitor changes in state-level Medicaid programs and adapt… more
- Veterans Affairs, Veterans Health Administration (Philadelphia, PA)
- …you like to become a part of a team providing compassionate whole health care to Veterans? Responsibilities The Wound/Ostomy Nurse Practitioner is a Baccalaureate ... Practitioner is a Medical Center consultant to patients with wound or ostomy issues , and assesses, plans, implements and evaluates skin care related to wounds and… more