• Registered Nurse Regulatory & Accreditation…

    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-4:00p ... 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 RN Regulatory… more
    Penn State Health (07/26/25)
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  • Director, Health Economics and Market…

    Olympus Corporation of the Americas (Center Valley, PA)
    …or medical device industry. + In-depth knowledge of (US) healthcare systems, health policy , including managed care organizations, IDN's, Medicare and ... in US reimbursement coding, coverage and innovative payment pathways, and US health policy . + Intermediate-level competence in epidemiology, clinical trials,… more
    Olympus Corporation of the Americas (06/25/25)
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  • Medical Director - Care Plus - Florida

    Humana (Harrisburg, PA)
    …in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines ... to help people with Medicare, or both Medicare and Medicaid , achieve their best possible health and...communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee… more
    Humana (09/04/25)
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  • UM Behavioral Health Professional

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health ... services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and frequently require… more
    Humana (09/04/25)
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  • VP Risk Adjustment Accuracy Management

    Highmark Health (Blue Bell, PA)
    …management for all government program products (commercial ACA, Medicare, and Medicaid ). Establishes the strategic direction for the Risk Revenue Management process, ... risk adjusted government programs (Medicare Advantage, ACA business, and Medicaid ). Also work with Care Management to ensure that...degree + Ten or more years' work experience in health care with emphasis on analysis and process optimization… more
    Highmark Health (07/30/25)
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  • Social Services Care Manager, Behavioral…

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Social Services Care Manager, Telephonic Behavioral Health 2, in a telephonic ... in care within the community. The **Social Services Care Manager** , Behavioral Health is a **Licensed,** **Masters level, Social Worker** who functions as an… more
    Humana (09/05/25)
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  • Representative II, Accounts Receivable

    Cardinal Health (Harrisburg, PA)
    …state or local law._ _To read and review this privacy notice click_ here (https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal- health ... company when necessary. + Bills supplemental insurances including all Medicaid states on paper and online. + Mails all...& rejections for re-submission (billing) in accordance with company policy , regulations, or third-party policy . + More… more
    Cardinal Health (08/24/25)
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  • Director Risk Adjustment, Coding & Quality

    Highmark Health (Pittsburgh, PA)
    …applicable guidelines, regulations and laws established by the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services ... continuous improvements as it relates to Quality and Coding for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs comply with all… more
    Highmark Health (08/08/25)
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  • Profee Medical Coder Complex Surgical Pediatric

    Banner Health (PA)
    …**Privacy Policy :** Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy) EOE/Female/Minority/Disability/Veterans Banner Health ... with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work(R) Certification (TM) . This recognition… more
    Banner Health (09/06/25)
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  • Physician-based Oncology Senior Complex Coder

    Banner Health (PA)
    …**Privacy Policy :** Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy) EOE/Female/Minority/Disability/Veterans Banner Health ... with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work(R) Certification (TM) . This recognition… more
    Banner Health (09/05/25)
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