• Director Risk Adjustment, Coding & Quality

    Highmark Health (Pittsburgh, PA)
    …with all applicable guidelines, regulations and laws established by the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services ... (HHS), and others established at the state and federal levels. Drives efficient operational functions to achieve established Quality measures, STARS and HEDIS performance ratings. Directs and manages team of ~75 employees that are health plan and… more
    Highmark Health (08/08/25)
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  • Clinical Reimbursement Coordinator, RN

    Genesis Healthcare (York, PA)
    …of care. *Manage the overall process and tracking of all Medicare /Medicaid case-mix documents to assure appropriate reimbursement for services provided within ... the nursing center. *Conduct concurrent MDS reviews to assure achievement of maximum allowable RUG categories. *Integrate information from nursing, dietary, social services, restorative, rehabilitation, and physician services to ensure appropriate… more
    Genesis Healthcare (08/08/25)
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  • Behavioral Health Technician I-Mobile

    WellSpan Health (Mount Gretna, PA)
    …health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and ... one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000… more
    WellSpan Health (08/08/25)
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  • Field Case Manager, Registered Nurse (Danville,…

    CVS Health (Bensalem, PA)
    …(diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members. - 2 years Case Management, discharge planning, and/or home ... health care coordination experience - Must be willing to travel 55-75% within designated areas **Preferred Qualifications** - Excellent analytical and problem-solving skills - Effective communications, organizational, and interpersonal skills. - Ability to… more
    CVS Health (08/08/25)
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  • Manager Non-invasive Vascular Lab,…

    Highmark Health (Pittsburgh, PA)
    …activities and monitors the outcomes. (10%) + Completes and maintains NIA/ Medicare applications specific to vascular lab services at all Physician Organization ... locations. (5%) **QUALIFICATIONS:** Minimum + Bachelor's degree or 6 years of relevant experience and/or education as determined by the company in lieu of bachelor's degree + Registered Vascular Technologist (RVT) and/or Registered Diagnostic Cardiac… more
    Highmark Health (08/08/25)
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  • Hospice Nurse Practitioner Per Diem / Flex

    Gentiva (Shamokin Dam, PA)
    …experience in hospice, palliative care, or geriatrics + Strong understanding of Medicare hospice regulations and eligibility criteria + Experience providing care in ... home-based or facility settings + Prior experience completing F2F or recertification visits in hospice or home health + Confident, independent practitioner with excellent communication and documentation skills **We Offer** **Benefits for All Associates… more
    Gentiva (08/08/25)
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  • Patient Access Assistant I-Ambulatory…

    WellSpan Health (Waynesboro, PA)
    …health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and ... one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000… more
    WellSpan Health (08/08/25)
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  • Sterile Processing Technician II - York Hospital…

    WellSpan Health (York, PA)
    …health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and ... one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000… more
    WellSpan Health (08/08/25)
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  • Electrophysiology Technologist - Cardiac Cath…

    WellSpan Health (Lebanon, PA)
    …health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and ... one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000… more
    WellSpan Health (08/08/25)
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  • Sleep Technologist - York Neuro and Sleep Center…

    WellSpan Health (Dover, PA)
    …health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and ... one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000… more
    WellSpan Health (08/08/25)
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