• Utilization Management Nurse

    CenterWell (Harrisburg, PA)
    …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life… more
    CenterWell (08/02/25)
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  • Operations Specialist / Administrative Assistant

    Aveanna Healthcare (Bala Cynwyd, PA)
    …time with or without notice. Vaccine Requirement As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in ... for medical or religious reasons as appropriate. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in… more
    Aveanna Healthcare (08/02/25)
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  • Accounting Manager, Revenue and Reporting

    WelbeHealth (Harrisburg, PA)
    …+ Assist with month-end close, quarterly financial reporting, financial audit, Medicare /Medicaid audits, and other PACE specific projects + Keep a ... payment model, including ability to track and analyze revenue streams (eg Medicare , Medicaid, Part D) along with PACE rates and regulatory constructs **Job… more
    WelbeHealth (08/01/25)
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  • Director Stars and Quality - remote

    Prime Therapeutics (Harrisburg, PA)
    …strategic plans that achieve Star Ratings and quality outcomes for Medicare , Medicaid, Individual Health Insurance Marketplace, and Commercial lines of business. ... the client quality support model strategy for all lines of business ( Medicare , Medicaid, commercial/HIM); serve as primary enterprise point of contact and subject… more
    Prime Therapeutics (08/01/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Harrisburg, PA)
    …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
    Evolent (07/30/25)
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  • Program Manager III - Account Management

    AON (Fort Washington, PA)
    …Term Care (New York Life), Auto & Home (Liberty Mutual), and Medicare Supplement (Transamerica). Your responsibilities will include managing complex client matters ... Term Care (New York Life), Auto & Home (Liberty Mutual), and Medicare Supplement (Transamerica). Your responsibilities will include managing complex client matters… more
    AON (07/29/25)
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  • Field Reimbursement Manager

    Adecco US, Inc. (Philadelphia, PA)
    …readiness and adoption. 7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights ... authorizations, and/or claim adjudication, physician's office or clinics. * Must have Medicare and commercial insurance coverage experience. * Must be able to… more
    Adecco US, Inc. (07/26/25)
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  • Registered Nurse Regulatory & Accreditation…

    Penn State Health (Lancaster, PA)
    …of Health, the Attorney General, The State Board of Pharmacy and Centers for Medicare and Medicaid Services. The importance of having a RN Regulatory & Accreditation ... & Accreditation Program Coordinator-Quality, helps maintain compliance to Centers for Medicare and Medicaid Conditions of Performance and legal protection for… more
    Penn State Health (07/26/25)
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  • Compliance Analyst Principal (Performance…

    Prime Therapeutics (Harrisburg, PA)
    …Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) + Must be eligible ... Advanced degree in related area of study, such as Juris Doctor + Medicare Part D, Medicaid, and/or Affordable Care Act knowledge and experience **Physical Demands**… more
    Prime Therapeutics (07/25/25)
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  • Medical Economics Senior Manager

    CVS Health (Harrisburg, PA)
    …supporting complex Capitation analyses that support our strategic goals for Medicaid, Medicare , IFP and commercial, and working collaboratively with the Network to ... healthcare data, metrics & coding structures + Understanding of both Commercial and Medicare plans to help network partners to make sound decisions to drive… more
    CVS Health (07/24/25)
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