- Highmark Health (Pittsburgh, PA)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job is responsible for the day-to-day direction of all risk and compliance assessment ... activities of Highmark Health across a broad range of frameworks including NIST,...+ Manages program to perform on-site third party audits, regulatory reviews, vendor risk reviews,and validates necessary remediations to… more
- Highmark Health (Harrisburg, PA)
- …and investigative purposes to comply with internal audit and regulatory requirements. **ESSENTIAL RESPONSIBILITIES** + Performs investigations into potential and ... to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for completing all necessary field (externally)… 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 ... part of our caring community and help us put health first** The Behavioral Health Medical Director...be authorized. All work occurs within a context of regulatory compliance and work is assisted by diverse resources… more
- Highmark Health (Harrisburg, PA)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical ... routine and non-routine audits of clinical information, assessing medical policy adherence and consistency in decision-making, identifying non-compliance issues, and… more
- Lumen (Harrisburg, PA)
- …Public Affairs Communications will lead strategic communications to support Lumen's public policy , legislative and regulatory priorities at the federal, state ... to government affairs leadership, providing strategic communications counsel on public policy , regulatory developments, and reputational risk. Translate complex … more
- WellSpan Health (Gettysburg, PA)
- …Manager will maintain a consistent on-site presence at the York behavioral health crisis center, serving as the clinical and operational leader during scheduled ... will be expected to support training, staff engagement, and regulatory compliance across locations. **On-Call Expectations** On-call responsibilities are currently… more
- Highmark Health (Pittsburgh, PA)
- …including the electronic medical record. (10%) + Ensures compliance with regulatory requirements and accreditation standards in Health Information Management ... **Company :** Allegheny Health Network **Job Description :** GENERAL OVERVIEW: The...to assure compliance with JC, DOH, CMS and other regulatory bodies on requirements for documentation and record completion.… more
- Veterans Affairs, Veterans Health Administration (Philadelphia, PA)
- …and administrative responsibilities. Assures compliance with accrediting agency and regulatory requirements, and the quality management program, assuring corrective ... program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Qualifications Basic Requirements: Citizenship. Citizenship of the… more
- Highmark Health (Pittsburgh, PA)
- …Medicaid industry trade groups and associations. Monitor and shape legislative and regulatory developments, participate in policy discussions, and contribute to ... with provider partners to improve collaboration and care coordination. + **State and Regulatory Relations:** Serve as the primary point of contact for federal &… more
- Intermountain Health (Harrisburg, PA)
- …HIM Analyst II will collect, process, retrieve, analyze, and disseminate health care information/medical records for purposes of patient care, Subpoenas, attorney, ... regulatory and Risk Management requests. The incumbent will perform...all requests are compliant, adhering to hospital and clinic policy as well as State and Federal guidelines. Scope… more