- CVS Health (Blue Bell, PA)
- …all Aetna geographies, Medicare Advantage market actuaries, and associated Medicaid actuaries. Establish best practices, ensure consistency, and provide guidance ... for supporting the IVL MA actuarial team, local market partners, and Medicaid partners to provide a best-in-class bid product, with emphasis on compliance… more
- UPMC (Pittsburgh, PA)
- …as a registered pharmacist (RPh), in the Commonwealth of Pennsylvania or eligibility for licensure by examination or reciprocity is required. This job provides ... management of the designated line of business (Commercial, Exchange, Medicare, Medicaid , Exchange, and/or CHIP) from a pharmacy formulary and operational perspective… more
- Cognizant (Harrisburg, PA)
- …features. * Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and ... government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other regulatory requirements. **Work Model:** We strive to… more
- Aveanna Healthcare (Beaver Falls, PA)
- …individual. Must be 18 or older. Ability to work flexible hours as needed. Eligibility for State Police Criminal Record Check and Child Abuse History Clearance. FBI ... any time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant… more
- Aveanna Healthcare (Ellwood City, PA)
- …individual. Must be 18 or older. Ability to work flexible hours as needed. Eligibility for State Police Criminal Record Check and Child Abuse History Clearance. FBI ... any time with or without notice. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant… more
- UPMC (Camp Hill, PA)
- …physical disabilities in the Commonwealth who are covered by Medicare and Medicaid . To provide service coordination services across the continuum of care through ... access to needed LTSS and Medical Assistance services, as well as non- Medicaid funded medical, social, housing, educational, and other services and supports.… more
- CVS Health (Harrisburg, PA)
- …the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required. +… more
- CVS Health (Harrisburg, PA)
- …willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + Familiarity with community resources and services. + Ability ... **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with individuals with SDoH needs,… more
- UPMC (Pittsburgh, PA)
- …Medical Assistance! Additionally, CHC is also for individuals that qualify for Medicare, Medicaid , or require a nursing facility level of care. The CHC Service ... access to needed LTSS and Medical Assistance services, as well as non- Medicaid funded medical, social, housing, educational, and other services and supports.… more
- Cognizant (Harrisburg, PA)
- …features. . Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and ... government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other...processes for individual, group, and government-sponsored health plans (Medicare, Medicaid , ACA). . Strong understanding of CMS, ACA, and… more