- Humana (Harrisburg, PA)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health ... and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided...providers, clinical group practice management . + Utilization management experience in a medical management… more
- Centene Corporation (Harrisburg, PA)
- …changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national ... Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions... medical review of complex, controversial, or experimental medical services , ensuring timely and quality decision… more
- Humana (Harrisburg, PA)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Medical Assistant's primary responsibility is to assist in the delivery of healthcare support ... for the practice. The Medical Assistant is a professional member of the interdisciplinary...with recent test results and correspondence and determines needed services by conferring with the provider. 2. Completes pre-charting… more
- Travelers Insurance Company (Harrisburg, PA)
- … capabilities to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical … more
- Highmark Health (Harrisburg, PA)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...**Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral &… more
- CVS Health (Pittsburgh, PA)
- …Neurosurgery, including post-graduate direct patient care experience specifically. Expands Aetna's medical management programs to address member needs across the ... continuum of care. Supports the Medical Management staff ensuring timely and consistent...providers and facilities to support the effective execution of medical services programs by the clinical teams.… more
- CVS Health (Harrisburg, PA)
- …implementation, and evaluation of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum of ... care. You will support the Medical Management staff ensuring timely and consistent...providers and facilities to support the effective execution of medical services programs by the clinical teams.… more
- Highmark Health (Mcmurray, PA)
- …manner. + Prepares exam room for patient visit. Ensures adequate inventory of medical supplies. Ensures all patient treatment areas are at all times stocked with ... + High School / GED + Completion of a Medical Assistant Program **OR** 1 year of Medical...the email below. For accommodation requests, please contact HR Services Online at ###@highmarkhealth.org California Consumer Privacy Act Employees,… more
- UPMC (Pittsburgh, PA)
- …including robotic prostatectomies and bladder resections. We offer a wide range of medical management . New and experienced nurses will experience an exciting ... Pavilion has 30 private beds and is primarily orthopedic service line including elective joint replacements, joint revisions and...range of services including wound care, surgical recovery, patient education, and… more