- Highmark Health (Pittsburgh, PA)
- …the completion of other ad-hoc financial planning activities and assist in the development and review of business cases for strategic initiatives. Train, coach ... and develop staff members. **ESSENTIAL RESPONSIBILITIES** + Oversee the development of the semi-annual financial forecast. This includes ensuring the source data… more
- Humana (Harrisburg, PA)
- …Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team responsible for administering complex Medicare provider ... reimbursement methodologies. The business needs of the team continue to evolve and...needed to accommodate CMS logic. + Assisting with requirements development . + Creating and executing comprehensive test plans +… more
- J&J Family of Companies (Spring House, PA)
- …**Preferred:** + 2 years of people management experience + Familiarity with healthcare compliance and other relevant guidance ( HIPAA , FCPA, Safe Harbor, etc.) + ... for:** **Process** + Oversee end-to-end payment process, ensuring accuracy, compliance with company policies and regulatory requirements, and adherence to… more
- Highmark Health (Erie, PA)
- … development and establishing and monitoring laboratory QA and compliance with ICAEL and other regulatory agencies. **ESSENTIAL RESPONSIBILITIES:** + Functions ... and performs cardiac imaging studies. (30%) + Participates in the selection and development of staff ensuring competency and holding staff to high standards of… more
- Penn Medicine (Philadelphia, PA)
- …academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will ... improve unit/department operations to maintain and exceed internal/external regulatory compliance and achieve clinical excellence. Participates in and supports… more
- Humana (Harrisburg, PA)
- …Counsel o Internal Compliance o Market Areas o Clinical Teams o Business areas for all product lines (Medicare, Medicaid, Commercial) o Industry Trend areas ... o Interview skills and able to conduct a thorough investigation to maintain compliance with Humana and governmental requirements o Able to collaborate with internal… more
- Highmark Health (Pittsburgh, PA)
- …all activities surrounding the research in the department to ensure compliance with internal and external regulatory agencies. ESSENTIAL RESPONSIBILITIES: + Promotes ... growth and development of research through networking activities with internal and...agencies. Acts as a liaison to facilitate study progress, compliance and enrollment. (30%) + Evaluates the workload of… more
- WellSpan Health (York, PA)
- …that pertain to both payor contracts and hospital operations (ie, Act 68, HIPAA , Surprise Billing) ensuring appropriate compliance requirements are kept by ... Participates in third party payor contract negotiations and manages contract performance compliance for the System to ensure fair and adequate payment rates,… more
- The Cigna Group (Philadelphia, PA)
- …operational excellence. This role will lead a cross-functional team of clinical and business leaders to build solutions, processes and functions that ensure a high ... work closely with the CMOs, policy teams, safety infrastructure, compliance and legal teams, and technology teams to drive...and federal regulation and with healthcare quality standards, including HIPAA , JCAHO, and CMS as well as HEDIS, NCQA… more
- Humana (Harrisburg, PA)
- …and develops engaging, learner-centered experiences that drive performance and skill development . Collaborate with subject matter experts to analyze learning needs, ... Knows how to select and use appropriate learning technologies to support development and delivery (Articulate, Vyond, Cornerstone on Demand, etc.) and collaborative… more