- WellSpan Health (Lewisburg, PA)
- …members of the health care team. Primary responsibilities include identification of Medicare patients appropriate for Annual Wellness Visits (AWV) and execution of ... Functions:** + Review office schedules and identify patients appropriate and due for Medicare AWV. + Work collaboratively with clinical teams to accomplish AWV in an… more
- Humana (Harrisburg, PA)
- …+ 3+ years of SQL experience, preferably in SSMS. **Preferred Qualifications** + Medicare Advantage experience. + Experience with SQL and VBA highly preferred. + ... role is part of a team that owns the Medicare Advantage pricing methodology and supporting tools in the...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Humana (Harrisburg, PA)
- …of the responsibilities: + Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if there ... proper entries to the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance regulations to establish required… more
- Humana (Harrisburg, PA)
- …approvals, as well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, ... + PharmD + Health Plan experience + Knowledge of Medicare as it relates to pharmacy + Six Sigma...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Humana (Harrisburg, PA)
- …This role will support a few tools used within our Individual Medicare Advantage pricing and internal reporting process. This includes: + Helping make ... Qualifications** + Strong technical skills, especially SQL and VBA + Individual Medicare Advantage experience Travel: While this is a remote position, occasional… more
- Humana (Harrisburg, PA)
- …Principal coordinates, implements, and manages oversight of the company's Medicare /Medicaid Stars Program for aligned areas. The Stars Improvement Principal ... etc. + 5 years or more of CMS Stars program experience + Medicare Advantage experience + Previous leadership experience as a people leader, leading through… more
- Humana (Harrisburg, PA)
- …expert on the End Stage Renal Disease (ESRD) population for Humana's individual Medicare Advantage plans. This includes: + Owning and improving our ESRD claims ... technical skills, especially SQL, VBA, and Databricks/Python + Individual Medicare Advantage experience + Knowledgeable on ESRD population **Additional Information**… more
- Humana (Harrisburg, PA)
- …Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and ... role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Prime Therapeutics (Harrisburg, PA)
- …in a manner that meets the specialized needs of the targeted population; for Medicare , is Centers for Medicare & Medicaid Services (CMS) compliance compliant + ... operations (eg workflow processes and case management) + Government programs ( Medicare ) knowledge **Preferred Qualifications** + Contact Center experience + Pharmacy… more
- Humana (Harrisburg, PA)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical ... management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with… more