• Supervisor Provider Data Quality Management…

    Highmark Health (Harrisburg, PA)
    …a formal or informal capacity **Preferred** + 1 year of experience performing Medicaid and /or Medicare systems setup of provider contracts and provider demographics ... + Understanding of software applications used Highmark Wholecare(R), such as Managed Health Care System, CACTUS, OnBase Document Management and/or OnBase Workflow +… more
    Highmark Health (08/22/25)
    - Related Jobs
  • Tele Psychiatrist-Expert

    Health Advocates Network (Blairsville, PA)
    …of current professional CPR certificate Must have ? DEA number ? Valid Medicare/ Medicaid ID number ? Evidence of malpractice or applicable insurance. ? Basic ... by the Commonwealth of Pennsylvania, Client, Office of Mental Health and Substance Abuse Services. The Staff Psychiatrist will...order to develop a plan of correction or draft policy /procedure for the hospital and/or clinical division. ? Develops… more
    Health Advocates Network (07/18/25)
    - Related Jobs
  • Senior Financial Analytics Professional

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** CenterWell's Home Solutions Organization is a leading provider of home-based care and ... post-acute value-based services. The Home Health Business Unit is one of the largest providers...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (09/03/25)
    - Related Jobs
  • Delaware Valley ACO Fellowship

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Delaware Valley ACO (DVACO) is an accountable care organization that participates in the ... Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus other...venture among three stakeholders: Humana (majority owner), Main Line Health System, and Jefferson Health System. Humana… more
    Humana (07/30/25)
    - Related Jobs
  • RN Care Manager - Remote, nationwide

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and ... techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient… more
    Humana (09/06/25)
    - Related Jobs
  • Stars Program Delivery Lead - HEDIS Controlling…

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** Health Quality and Stars (HQS) is an organization that is responsible for improving ... health outcomes and advancing the care experience of our...quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system… more
    Humana (09/03/25)
    - Related Jobs
  • Stars Operations Strategy Lead

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** Health Quality and Stars (HQS) is an organization that is responsible for improving ... health outcomes and advancing the care experience of our...quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system… more
    Humana (09/06/25)
    - Related Jobs
  • Compliance Analyst Principal - Remote

    Prime Therapeutics (Harrisburg, PA)
    …participates inclient and stakeholder meetings + Reviews proposedfederal and state public policy and rule changes and prepares position papers for internal and ... client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned **Education & Experience** + Bachelor's… more
    Prime Therapeutics (07/07/25)
    - Related Jobs
  • Stars Program Delivery Senior Professional - HEDIS…

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** Health Quality and Stars (HQS) is an organization that is responsible for improving ... health outcomes and advancing the care experience of our...quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system… more
    Humana (09/03/25)
    - Related Jobs
  • Income Maintenance Caseworker - Tioga CAO

    Commonwealth of Pennsylvania (PA)
    …position is responsible and accountable for determining eligibility for financial assistance, Medicaid , SNAP, LIHEAP, nursing home care and waivers as well as any ... office setting environment. Major duties include determining eligibility for financial assistance, Medicaid , SNAP, LIHEAP, nursing home care, and waivers as well as… more
    Commonwealth of Pennsylvania (09/08/25)
    - Related Jobs