• HEDIS Program Manager II

    Centene Corporation (Harrisburg, PA)
    …As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:** ... Quality Improvement projects, programs highly preferred. + Knowledge of Medicaid, Medicare government programs preferred. Pay Range: $68,700.00 - $123,700.00 per… more
    Centene Corporation (10/23/25)
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  • Manager Reimbursement Services (CPC, CRC,…

    Geisinger (Danville, PA)
    …that accurate predictive modeling is done by line of business ( Medicare versus Commercial). + Recommends reimbursement opportunities by utilizing statistical ... typical elements considered necessary to successfully perform the job. #LI- REMOTE Position Details Education Bachelor's Degree- (Required), Bachelor's Degree-Business… more
    Geisinger (10/31/25)
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  • PCO Medical Director- UM - Full Time

    CenterWell (Harrisburg, PA)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
    CenterWell (11/06/25)
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  • Pharmacist - Clinical Operations Advisor

    CVS Health (Harrisburg, PA)
    …create a clinical operations plan. The Clinical Operations Advisor works with the Benefit Relationship Manager and client to facilitate gathering formulary and ... of business including Medicare , Medicaid, Exchange, and Commercial. This is a remote role, open to qualified candidates within the Central or Eastern time zones… more
    CVS Health (11/26/25)
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  • Community Relations Representative

    AmeriHealth Caritas (Harrisburg, PA)
    …Must be able to move freely within a community setting. **Our Comprehensive Benefits Package** Flexible work solutions include remote options, hybrid work ... **Responsibilities:** Under the supervision of the Manager , Community Outreach Programs, this position develops, promotes, and implements Community Health Choices… more
    AmeriHealth Caritas (09/12/25)
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  • Application Support Specialist Lead

    AmeriHealth Caritas (West Chester, PA)
    …services. Discover more about us at; www.amerihealthcaritas.com . **Our Comprehensive Benefits Package** Flexible work solutions including remote options, hybrid ... developer role.;_** **Work Arrangement** + This is a 100% Remote position but you must live in EST or...user access policies and procedures + Provide input to manager on staff performance relating to technology but does… more
    AmeriHealth Caritas (11/13/25)
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  • Utilization Management RN

    CenterWell (Harrisburg, PA)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... in utilization management within Insurance industry a plus + Previous Medicare Advantage/ Medicare **Alert** Humana value's personal identity protection. Please… more
    CenterWell (11/26/25)
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  • Quality Professional, Growth and Retention…

    CenterWell (Harrisburg, PA)
    …one of the largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the ... the Tele Sales Agents who are responsible for converting Medicare eligible callers to patients. The Care Delivery Call...PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training… more
    CenterWell (11/25/25)
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  • Special Needs Plan- Support Social Services

    Humana (Harrisburg, PA)
    …part of our caring community and help us put health first** The Care Manager , Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates ... with resources appropriate for the care and wellbeing of members. The Care Manager , Telephonic Behavioral Health 2 work assignments are varied and frequently require… more
    Humana (11/06/25)
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  • Supervisor - Home Health - West Region - Days

    WellSpan Health (York, PA)
    Full Time (80 Hours Biweekly) Hybrid Onsite/ Remote (more than 50% onsite) 8-430pm with on-call responsibilities Day Shift **General Summary** Responsible for ... current programs and policies. Assumes the responsibilities of the Clinical Manager as designated. **Duties and Responsibilities** **Essential Functions:** + Related… more
    WellSpan Health (11/29/25)
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