• Director, Quality and Risk

    St. Luke's University Health Network (Orwigsburg, PA)
    …Professional in Healthcare Quality (CPHQ) or Certified Professional in Healthcare Risk Management (CPHRM) or appropriate alternative within 2 years ... and Patient Safety is responsible for all aspects of Quality , Clinical Risk Management and...and near vision. EDUCATION: Bachelor's degree in nursing or healthcare related field is required. Master's Degree preferred or… more
    St. Luke's University Health Network (08/08/25)
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  • Manager Risk & Quality Assurance

    Highmark Health (Camp Hill, PA)
    …Inc. **Job Description :** **JOB SUMMARY** This job has oversight responsibility for all risk & quality assurance studies required by regulators, the Blue Cross ... performance guarantees / service level agreements, and (f) employee performance quality . **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to… more
    Highmark Health (08/15/25)
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  • Director Risk Adjustment, Coding…

    Highmark Health (Pittsburgh, PA)
    …**Required** + 7 - 10 years in the Healthcare Industry + 5 - 7 years in Management + 5 - 7 years in Risk Revenue **Preferred** + 3 - 5 years in Consulting ... record documentation and coding. Promotes the strategy and capabilities to develop risk management and physician / member initiatives that support provider… more
    Highmark Health (08/08/25)
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  • VP Risk Adjustment Accuracy…

    Highmark Health (Blue Bell, PA)
    …on providing optimal financial returns in a fully compliant manner. Develop a Risk Management governance strategy for the Enterprise to appropriately manage CMS ... Description :** **GENERAL OVERVIEW:** This position is responsible for risk revenue management for all government program...Lead a team that develops and oversees analysis of risk adjustment programs including ROI, productivity, quality ,… more
    Highmark Health (07/30/25)
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  • Senior Risk Partner Management

    Highmark Health (Pittsburgh, PA)
    …to define the development, implementation and maintenance of an effective compliance and risk management program for the supported entities. This includes, but ... related field **EXPERIENCE** **Required** + 7 years in Compliance, Privacy, Government Affairs, Healthcare Operations, Risk , Audit, or legal functions + 5 years… more
    Highmark Health (08/29/25)
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  • Senior Risk Management Specialist

    UPMC (Pittsburgh, PA)
    UPMC Corporate Legal is seeking a Senior Risk Management Specialist to join the team in Oakland, PA. This hybrid role offers a mix of onsite and remote work. ... Reporting to the Senior Manager, Corporate Risk Management , the role involves systematically managing...and developing corrective action plans in conjunction with appropriate management and staff. Conduct high quality in-depth… more
    UPMC (08/08/25)
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  • Enterprise Risk Management Analyst…

    Prime Therapeutics (Harrisburg, PA)
    …our passion and drives every decision we make. **Job Posting Title** Enterprise Risk Management Analyst Senior - Remote **Job Description** The Senior Enterprise ... Risk Management (ERM) Analyst is responsible for...and devising and recommending solutions **Preferred Qualifications** + Managed healthcare , health insurance, or other highly regulated industry +… more
    Prime Therapeutics (08/31/25)
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  • Enterprise Risk Management Analyst…

    Prime Therapeutics (Harrisburg, PA)
    …fuels our passion and drives every decision we make. **Job Posting Title** Enterprise Risk Management Analyst - Remote **Job Description** The Enterprise Risk ... and developing strategies to mitigate and manage risks. The role supports implements risk management policies and procedures, conducts risk assessments,… more
    Prime Therapeutics (08/31/25)
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  • Associate Medical Director, Pharmacovigilance…

    Sumitomo Pharma (Harrisburg, PA)
    …event coding, concomitant medication coding, and causality statements. + Contributes to Risk Management Plans (RMPs)/ Risk Evaluation and Mitigation Strategy ... in oncology is highly desired + **Advanced understanding of pharmacovigilance and risk management regulations and guidelines, including pre- and post-marketing… more
    Sumitomo Pharma (08/15/25)
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  • Director, Prospective + Concurrent Risk

    Datavant (Harrisburg, PA)
    …**Required** + 8+ years of product management experience in healthcare , including ownership of clinical, risk adjustment, or provider-facing solutions. ... multi-year plans aligned to customer outcomes, regulatory drivers, and market trends in risk adjustment, care management , and provider enablement. + Identify and… more
    Datavant (08/08/25)
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