• Utilization Management Administration Coordinator…

    Humana (Harrisburg, PA)
    …non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. The Home Solutions UM Team is ... support for the policies and procedures ensuring best and most appropriate treatment, care or services for members utilizing Home Health and Skilled Nursing… more
    Humana (08/23/25)
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  • Program Lead, Patient Service Advisor Program

    CenterWell (Harrisburg, PA)
    …put patients at the center. As the nation's largest provider of senior-focused primary care , one of the largest providers of home health services, and fourth ... / Conviva Clinics and Leadership Workshops as needed. **Additional Information** To ensure Home or Hybrid Home /Office employees' ability to work effectively, the… more
    CenterWell (07/30/25)
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  • Utilization Management Strategy Lead

    Humana (Harrisburg, PA)
    …general technical difficulties in a remote environment. **Role Desirables** + Health care industry experience **Workstyle:** Remote work at Home **Location:** US ... enable members to receive the most appropriate type of care as quickly as possible all while streamlining processes...that is best for your schedule. **Remote Work at Home Guidance** To ensure Home or Hybrid… more
    Humana (08/23/25)
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  • Senior Director Hospital Coding

    Intermountain Health (Harrisburg, PA)
    …position will allow you to work in a fully remote / work from home capacity, with required periodic travel to Broomfield, Colorado.** **Currently, we are not hiring ... to drive performance improvement, efficiency and/or to improve the patient/provider/ caregiver experience. + Identify, lead and drive quality and performance… more
    Intermountain Health (08/30/25)
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  • Supervisor-Ambulatory Clinical Operations-RN…

    WellSpan Health (York, PA)
    …encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central ... . Duties may include quality monitoring, patient assessments, direct patient care , triage, administration of IVs, and patient/ caregiver /staff education. Provides… more
    WellSpan Health (08/26/25)
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  • Supervisor-Ambulatory Clinical Operations-LPN…

    WellSpan Health (Reinholds, PA)
    …. Duties may include quality monitoring, patient assessments, direct patient care , and patient/ caregiver /staff education. Provides safe, therapeutic, efficient ... patients served. Functions as a member of the health care team at an intermediate nursing level to assist...compliance with the standards of the Patient Centered Medical Home and Neighborhood, and all WMG policies, procedures, and… more
    WellSpan Health (06/25/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Harrisburg, PA)
    …our caring community and help us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently operates about 340+ senior ... focused primary care centers in 15 states. The Regulatory Compliance team...CMC) + Experience with metrics and reporting **Additional Information** **Work-At- Home Requirements:** To ensure Home or Hybrid… more
    Humana (08/23/25)
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  • Bilingual Outbound Telephonic UM Coordinator

    Humana (Harrisburg, PA)
    …the policies and procedures ensuring best and most appropriate treatment, care or services for members. Bilingual Outbound Telephonic UM Administration Coordinator ... Utilization Review and/or Prior Authorization, preferably within a managed care organization. **Additional Information** **Work Schedule:** Monday-Friday 8am-5pm EST,… more
    Humana (08/23/25)
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  • Principal, Financial Planning & Analysis,…

    Humana (Harrisburg, PA)
    …patient's well-being. CenterWell Home Health specializes in personalized, comprehensive in- home care for patients managing a chronic condition or recovering ... put patients at the center. As the nation's largest provider of senior-focused primary care , one of the largest providers of home health services, and fourth… more
    Humana (08/19/25)
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  • Formulary and Medical Strategies Senior…

    Humana (Harrisburg, PA)
    …Medicaid line of business. + Utilizes broad understanding of pharmacy, managed care , PBM, market and regulatory insights to support the implementation of formulary ... or equivalent + 3+ years of experience in managed care or other pharmacy related field + 3+ years...time that is best for your schedule. **Work at home requirements:** To ensure Home or Hybrid… more
    Humana (08/20/25)
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