- Humana (Harrisburg, PA)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance . + ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- University of Pennsylvania (Philadelphia, PA)
- …Medicare regulations applicable to clinical trials. + Understanding interaction of Medicare regulations and/or third-party insurance to develop clinical trial ... Penn offers comprehensive medical, prescription, behavioral health, dental, vision, and life insurance benefits to protect you and your family's health and welfare.… more
- CenterWell (Harrisburg, PA)
- …Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **About us**… more
- Penn Medicine (Lancaster, PA)
- …good standing with Medicare , Medicaid, and other federal and state health insurance programs, ie not excluded from participation in Medicare , Medicaid or any ... Medicare , Medicaid, and other federal and state health insurance programs ie not excluded from participation in ...insurance programs ie not excluded from participation in Medicare or any other federal or state health … 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 ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance... Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees for producers… more
- Humana (Harrisburg, PA)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical… more
- UPMC (Pittsburgh, PA)
- …medical field. + Proficiency in medical terminology preferred. + Knowledge of insurance regulations, specifically Medicare , BC/BS, managed care plans and workers ... schedulers + Send/receive patient medical records in accordance with Health Insurance . Obtain lab/x-ray reports, hospital notes, referral information, etc. + Assists… more
- UPMC (Pittsburgh, PA)
- …+ Work independently and possess sound decision-making skills. + Knowledge of insurance regulations, specifically Medicare , BC/BS, managed care plans and workers ... and forward all necessary admission reservations/requisitions, including demographics and insurance information to hospitals. + Coordinate cases and communicates… more
- UPMC (Pittsburgh, PA)
- …essential. Work independently and possess sound decision-making skills. Knowledge of insurance regulations, specifically Medicare , BC/BS, managed care plans and ... and forward all necessary admission reservations/requisitions, including demographics and insurance information to hospitals. + Coordinate cases and communicates… more
- UPMC (Pittsburgh, PA)
- …+ Work independently and possess sound decision-making skills. + Knowledge of insurance regulations, specifically Medicare , BC/BS, managed care plans and workers ... and forward all necessary admission reservations/requisitions, including demographics and insurance information to hospitals. + Coordinate cases and communicates… more