- Aveanna Healthcare (West Chester, PA)
- …change at any time with or without notice. + As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all ... 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
- CVS Health (Harrisburg, PA)
- …or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with community ... the position. **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with individuals with… more
- CenterWell (Harrisburg, PA)
- …in utilization management within Insurance industry a plus + Previous Medicare Advantage/ Medicare **Alert** Humana value's personal identity protection. Please ... be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ###@myworkday.com with instructions on how to add the information into your official application on Humana's… more
- Prime Therapeutics (Harrisburg, PA)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the ... experience + Knowledge of the applicable line of business (eg, Medicare , Medicaid, Exchange, Commercial, Employer Group) Every employee must understand, comply… more
- CenterWell (Harrisburg, PA)
- …and monitoring the Tele Sales Agents who are responsible for converting Medicare eligible callers to patients. The Care Delivery Call Quality Professional is ... quality auditing experience + Understanding of value-based primary care and/or Medicare Advantage + Familiarity with healthcare systems and patient satisfaction… more
- UPMC (Camp Hill, PA)
- …individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid. To provide service coordination services across the continuum of ... needs through other sources, including services provided under Medical Assistance, Medicare or private insurance, and other community resources. + Actively… more
- Penn Medicine (Lancaster, PA)
- …30 days of hire. + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance programs, ie not excluded from ... participation in Medicare , Medicaid or any other federal or state health insurance program. + As outlined in unit based Plan for Provision of Care. \#LI-LJ1 We… more
- Cognizant (Harrisburg, PA)
- …based on the review of clinical documentation in accordance with Medicare , Medicaid, and third-party guidelines. . Effectively document and log claims/appeals ... Reviews can be based on InterQual, Milliman Clinical Guidelines (MCG), Medicare guidelines, and health insurer specific guidelines. . Review retro-authorizations in… more
- Humana (Harrisburg, PA)
- …+ Accounting/Finance knowledge/experience + Advanced SQL or similar + Medicare /Medicaid experience + Data architecture/solution architecture experience + Project ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Aveanna Healthcare (Scranton, PA)
- …active RN License in the state of application + Valid CPR Preferred: + Medicare Skilled Nursing experience + Basic understanding of Oasis + 1-year RN experience in ... a health care setting As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions,… more