- Health Advocates Network (Harrisburg, PA)
- …and analyzing complex medical information databases (A good working knowledge of Medicaid /Medical Assistance a plus, but not required) ' Role Description: Assist in ... the design and conduct of: Fiscal and program analyses to support Pennsylvania Medical Assistance Program decision-making processes. Analyses to support medical assistance business operating decisions and for tracking, reporting and controlling of Medical… more
- WellSpan Health (York, PA)
- …hospital/physician issues, complex contract negotiation and management, Medicare/ Medicaid reimbursement issues, regulatory compliance, patient issues, employment ... law, contract law, nonprofit corporate governance, tax and medical staff issues. + Maintains professional affiliations and enhances professional growth and development to keep abreast of latest trends in field of expertise. + Provides outstanding service to… more
- Help at Home (Allentown, PA)
- …manner and in compliance with local, State and Federal laws, Medicare/ Medicaid regulations and established personnel policies and procedures. + Performs other ... job-related duties as assigned. _This description reflects assignment of essential functions, management may assign or reassign duties and responsibilities to this job at any time that are not listed above._ **_Education and Experience:_** + Associates degree… more
- Gentiva (Blue Bell, PA)
- …to apply hospice principles, industry standards, and regulatory compliance (Medicare, Medicaid , JCAHO, ACHC) + Knowledge and compassion for terminally ill patients ... and their families + Ability to lead a diverse care team while adapting to the emotional and clinical needs of patients from various backgrounds + Strong interpersonal, organizational, and leadership skills + Competency in clinical documentation and technology… more
- Humana (Harrisburg, PA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information,… more
- CVS Health (Harrisburg, PA)
- …Care Anti-Fraud Association (AHFI), or have a minimum of three years Medicaid Fraud, Waste and Abuse investigatory experience. * Billing and Coding certifications ... such as CPC (AAPC)and/or CCS (AHIMA) * Knowledge of Behavioral Health policies and procedures is a plus * Experience working Behavioral Health fraud cases **Education** A Bachelor's degree, or an Associate's degree, with an additional three years (3 years… more
- Datavant (Harrisburg, PA)
- …and compliant onboarding and management of client data for MA, ACA, and Medicaid plans, ensuring HIPAA and CMS compliance + **Standard Data Specifications:** Develop ... and maintain standardized data specifications for Retrospective Coding Products + **Data Type Additions:** Prioritize new data types to enhance AI-driven coding accuracy + **Data Integration** + Lead efforts in collaboration with the Retrieval Product team to… more
- Philips (Pittsburgh, PA)
- …clinical evidence to physicians. + Being an expert on Medicare, Medicaid and private insurance coverage-criteria for InCourage vest therapy, while effectively ... educating healthcare teams in identifying patients who meet coverage criteria. Obtaining medical record documentation in order for coverage to be obtained. + Analyzing data to effectively target priority healthcare teams and create sales call routing. Capable… more
- Aveanna Healthcare (Tionesta, PA)
- …from diverse backgrounds to apply. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant ... jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California (https://www.aveanna.com/CaliforniaPrivacyNotices.html) Apply more
- Deloitte (Philadelphia, PA)
- …+ Health care reform including individual medical and small group markets and/or state Medicaid programs The wage range for this role takes into account the wide ... range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been… more