- Humana (Harrisburg, PA)
- …units in a manner that demonstrates operational value and reduces compliance risk exposure for the organization. The Associate Director, Regulatory Intake Compliance ... understanding and working within Enterprise Solution Point (ESP) data, including risk assessment and scoring methodology and reporting or dashboard management using… more
- ChenMed (Philadelphia, PA)
- …will assess, evaluate, and coordinate the team's efforts to stabilize our highest risk patients, with special areas of focus including safe transitions of care from ... to our primary care teams, stabilization of our highest risk ambulatory patients and outreach to patients who are...90 days of employment We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare … more
- Evolent (Harrisburg, PA)
- …on organizational performance and patient health. This role supports capitated risk and value-based strategy development, medical cost management activity, medical ... capabilities and processes related to the development/underwriting of capitated risk proposals including cost & use projections, trend selection/development, and… more
- PNC (Pittsburgh, PA)
- …of the following areas is preferred: professional services, manufacturing, healthcare , wholesale, general services. **Job Description** + Handles relationship ... goals. Typically works with clients with basic levels of risk and complexity of needs. Generally works with higher...of credit and non-credit products and services. + Manages risk /return and drives quality for new and/or existing clients.… more
- GuideOne Insurance (Philadelphia, PA)
- …authority. You will fully review both new and/or renewal program business, assess risk of coverage, prepare quotes and respond to coverage questions, within the ... handles or provides support to a more complex state, risk , regulatory environment, and CAT exposure. + Takes a...Medical, dental and vision plans to meet your unique healthcare needs + Wellness incentives + Generous time off… more
- St. Luke's University Health Network (Bethlehem, PA)
- …position plays a key role in the coordination of organizational clinical risk management activities. Maintains a working knowledge of patient safety related ... Reporting process and is responsible for reviewing these events and investigating high- risk clinical issues. This position interacts with all levels of the… more
- Datavant (Harrisburg, PA)
- …company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right ... team. Together, we're rising to the challenge of tackling some of healthcare 's most complex problems with technology-forward solutions. Datavanters bring a diversity… more
- Penn State Health (Hershey, PA)
- …be a seasoned, transparent, and collaborative compliance leader within the healthcare industry and will be responsible for developing, implementing, and managing ... and outside counsel, executive management, and entity leadership regarding compliance risk areas. + Participate in the visioning and strategic identification of… more
- Geisinger (Danville, PA)
- …in the patient's medical record supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. Assists the ... providers with accurately identifying and documenting the healthcare services provided to the patient. Analyzes the clinical information, using the documentation as… more
- Highmark Health (Camp Hill, PA)
- …company policies. Effectively manage financial performance, quality control, and risk mitigation for all contracts under management. + **Relationship Management:** ... to stakeholders across all levels of the organization. + **Compliance & Risk Management:** Maintain awareness of all applicable federal, state, and local laws,… more