- Humana (Harrisburg, PA)
- …with Utilization Review and/or Prior Authorization, preferably within a managed care organization. **Additional Information** **Work Schedule:** Monday-Friday ... policies and procedures ensuring best and most appropriate treatment, care or services for members. Bilingual Outbound Telephonic UM...in special projects as assigned by your Supervisor or Manager **Use your skills to make an impact** **Required… more
- Penn Medicine (Berwyn, PA)
- …* Maintains comprehensive knowledge of reimbursement coverage from third party payers, managed care plans and protocols for referrals. * Performs duties ... our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future...of OR block time in a timely manner to manager for appropriate redistribution. Admin Duties * Answer and… more
- Penn Medicine (Philadelphia, PA)
- …referral and authorization requirements - proactively advises patients and staff on insurance/ managed care issues. Responsibilities: + Maintains up to date ... our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future...front end issues which may impact revenue process to Manager + Receives and responds to all correspondence, telephone… more
- Prime Therapeutics (Harrisburg, PA)
- …agreements. + Invoicing practices, including pre-invoicing review for fee for service, managed care , diabetic supply and supplemental rebate programs. + Assists ... assist with resource allocations and implementation activities and will escalate to the manager any issues theycannot resolve. Will remain up to date on current… more
- Prime Therapeutics (Harrisburg, PA)
- …function or similar area for a Pharmacy Benefit Manager (PBM), health plan, or managed care organization + Must be eligible to work in the United States ... for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded...and work collaboratively to provide the highest quality of care and service to our members. If you are… more
- CenterWell (Harrisburg, PA)
- …Medicare and/or Medicaid experience + 3 or more years clinical experience in managed care + Ability to manage end-to-end-processes + Understand Humana's business ... retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …+ In-depth knowledge of (US) healthcare systems, health policy, including managed care organizations, IDN's, Medicare and Medicaid; innovative reimbursement ... to Life, by advancing medical technologies and elevating the standard of patient care so people everywhere can fulfill their desires, dreams, and lives. Our five… more
- Stantec (Philadelphia, PA)
- When you care deeply about the work you do, it's rewarding to see it through from concept to completion. We partner with clients to provide both program management ... transit systems, water treatment facilities, mines, and wind farms, we've successfully managed thousands of projects. Joining our team, turning visionary ideas into… more
- Prime Therapeutics (Harrisburg, PA)
- …for key components such as the risk register, issue management, and incident manager + Other duties as assigned **Minimum Qualifications** + Bachelor's degree in ... independently and devising and recommending solutions **Preferred Qualifications** + Managed healthcare, health insurance, or other highly regulated industry +… more
- PNC (Pittsburgh, PA)
- …Field Exam due diligence process.Participates in meetings with the Relationship Manager and/or existing Borrower's representatives (typically the CFO, CEO and/or ... the Borrowing Base Certificates.Ensures that the Borrowing Base is in-compliance and being managed per the terms and conditions stipulated in the Loan Approval. +… more