- Humana (Harrisburg, PA)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- WTW (Philadelphia, PA)
- …contracting background. The preferred candidate may also have knowledge of ERISA, state insurance laws, Medicare , and/or experience in the employee benefits or ... prior in-house experience a plus but not required. + Employee benefits, Medicare , health insurance , ERISA and/or regulatory background preferred. + Strong… more
- Highmark Health (Pittsburgh, PA)
- …feature set. Highlights of the ideal candidate experience: * Strong knowledge of Medicare Advantage and D-SNP insurance products * Understanding of Medicare ... managing vendor relationships for health-related services * Experience analyzing Medicare Advantage insurance product financial performance * Experience… more
- UPMC (Pittsburgh, PA)
- …needs through other sources, including services provided under Medical Assistance , Medicare or private insurance and other community resources. + Actively ... Additionally, CHC is also for individuals that qualify for Medicare , Medicaid, or require a nursing facility level of...with HIPAA guidelines Licensure, Certifications, and Clearances: + Automotive Insurance + Driver's License + Act 34 UPMC is… more
- Fresenius Medical Center (Harrisburg, PA)
- …coordinate insurance options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal ... and annual indigent waivers. + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include… more
- UPMC (Camp Hill, PA)
- …identified needs through other sources, including services provided under Medical Assistance, Medicare or private insurance , and other community resources. + ... individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid. To provide service coordination services across the continuum of… 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 ... (work at home) + This role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside of bid season + The role… more
- BrightSpring Health Services (Altoona, PA)
- …comprehensive clinical assessments to determine eligibility for hospice based on Medicare / insurance guidelines + Coordinate the start of services (nursing, ... and timely documentation Benefits and Perks for You! + Medical, Dental, Vision insurance + Health Savings & Flexible Spending Accounts (up to $5,000 for childcare)… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer ... Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team continue to… more
- CVS Health (Harrisburg, PA)
- …talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part of a specialized team ... who will focus on educating existing Medicare members on available plan offerings to help meet...to pass, on an annual basis: + American Health Insurance Plans (AHIP) + Continued Education (CE's) + Product… more