- Highmark Health (Harrisburg, PA)
- …IT, Legal and other departments, proactively identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their ... processes, and implement effective controls and procedures to maintain compliance . This job performs business analysis tasks by supporting...Health Insurance Industry + 3 - 5 years the Healthcare Industry + 3 - 5 years in Lean/Six… more
- Highmark Health (Harrisburg, PA)
- …achieved. + Ensure all activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements and accreditation ... interviewing or dialectical behavior therapy (DBT) + Experience working with the healthcare needs of diverse populations + Understanding of the importance of… more
- WellSpan Health (York, PA)
- …UKG, and other applications and systems. + Maintain cybersecurity resilience, ensuring compliance with HIPAA , HITECH, and industry best practices. + Collaborate ... and enforce data governance practices to ensure accuracy, security, and compliance . **IT Infrastructure, Security & Operations** + Collaborate with multidisciplinary… more
- Evolent (Harrisburg, PA)
- …+ Offer **clinical rationale for standard and expedited appeals,** ensuring compliance with UM policies and regulatory requirements. + Collaborate with ... organizational skills.** + Passion for **value-based care and improving healthcare quality.** + **Computer proficiency** and ability to navigate...we'd love to hear from you! **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)),… more
- Highmark Health (Harrisburg, PA)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim… more
- Humana (Harrisburg, PA)
- …time with demonstrated advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The nature of the work ... computer applications. Due to the auto dialer process and compliance needs of the business there is limited day...space lacking ongoing interruptions to protect member PHI / HIPAA information **Additional Information - How we Value You**… more
- Humana (Harrisburg, PA)
- …performance, data integrity, and security through rigorous governance and proactive compliance practices. + Build a best-in-class Finance data and analytics function ... build stakeholder alignment, and drive innovation. + Familiarity with compliance standards, Finance data governance, and system audit-readiness. **Preferred… more
- Humana (Harrisburg, PA)
- …encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance ... Medicaid/Medicare + Ensure encounter submissions meet or exceed all compliance standards via analysis of data + Develop tools...space lacking ongoing interruptions to protect member PHI / HIPAA information** **Our Hiring Process** **As part of our… more
- Humana (Harrisburg, PA)
- …pillars, including continuous integration (CI), continuous delivery (CD), quality, security, compliance , metrics, and reporting. + Ensure compliance with ... space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position,...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- Prime Therapeutics (Harrisburg, PA)
- …risk mitigation, and regulatory interpretation + Demonstrated experience in federal healthcare laws and regulations such as HIPAA , Anti-Kickback Statute, ... **Additional Qualifications** + Advanced knowledge of PBM regulatory frameworks and healthcare law, with demonstrated ability to proactively identify and address… more