- Highmark Health (Camp Hill, PA)
- …relations and contracting efforts. This encompasses a broad portfolio including Medicaid , TRICARE Dental Program (TDP), and Active Duty Program (ADDP) contracts. ... on expanding United Concordia's footprint and market share within the Medicaid market. **ESSENTIAL RESPONSIBILITIES** + **Strategic Planning & Development:** Develop… more
- Humana (Harrisburg, PA)
- …care management, provider relations, quality of care, audit, grievance and appeal and policy review. The Behavioral Health Medical Director will develop and ... **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care… more
- Heritage Ministries (Conneautville, PA)
- …to complete all financial documents, explain billing procedures, and supervise the Medicaid process to ensure that the resident and/or responsible party fully ... the resident and/or responsible party. + Will assess when/if Medicaid assistance is needed. Explain the Medicaid ...compliance with facility policies and procedures and Department of Health regulations. + Maintains a neat, clean and orderly… more
- Highmark Health (Harrisburg, PA)
- …CHIP, Medicaid DE) and Enterprise Quality, Safety, and Values ( Health Outcomes Measures). Provide actionable opportunities in provider transformation aimed at ... Medicaid HEDIS, risk revenue value streams, and population health management. **Preferred** + 7 years of experience in...all areas of the corporation, by understanding corporate strategies, policy , and scope of authority + Because of the… more
- WellSpan Health (York, PA)
- …Crowe RCA tool. Assists in preparation and filing of Medicare and Medicaid cost reports, therefore, must stay abreast of current governmental reimbursement ... projections. + Assists in coordination, preparation, and submission of Medicare and Medicaid cost reports using data from company general ledger and patient… more
- Organon & Co. (Plymouth Meeting, PA)
- **Job Description** **The Position** The Women's Health Clinical Account Specialist (WHCAS) supports customers by providing clinical information on our Company's ... results that are consistent with the Company's mission and goals. The Women's Health Clinical Account Specialist is the primary point of contact for a variety… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure ... successful submission and reconciliation of encounter submissions to Medicaid /Medicare. Ensures encounter submissions meet or exceed all compliance standards via… more
- Penn State Health (Lancaster, PA)
- **Penn State Health ** - **Lancaster Medical Center** **Location:** US:PA:Lancaster **Work Type:** Full Time **FTE:** 1.00 **Shift:** Day **Hours:** 8:00a-4:30p ... not limited to The Joint Commission, The Department of Health , the Attorney General, The State Board of Pharmacy...State Board of Pharmacy and Centers for Medicare and Medicaid Services. The importance of having a Regulatory &… more
- Elevance Health (Harrisburg, PA)
- …government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and ... onboarding and skill development._ Please note that per our policy on hybrid/virtual work, candidates not within a reasonable...Medicaid Services (CMS) division of the Department of Health and Human Services). The Audit and Reimbursement Senior… more
- Penn State Health (Hershey, PA)
- **Penn State Health ** - **Community Medical Group** **Location:** US:PA: Hershey **Work Type:** Full Time **FTE:** 1.00 **Shift:** Day **Hours:** 8:00a - 4:30p ... grievances as defined by the Centers for Medicare and Medicaid Services (CMS) and as regulated by the Department...Services (CMS) and as regulated by the Department of Health (DOH), and to ensure compliance with all regulatory… more