- Prime Therapeutics (Harrisburg, PA)
- …or equivalent training and/or experience + Experience within the PBM industry, Medicaid, Medicare , and health plans + Pharmacist / Pharm D + Experience with contract ... ranges from $164,000.00 - $279,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page… more
- WellSpan Health (Mount Gretna, PA)
- …of care assessments as needed to facilitate referrals to treatment. + Helps to review and manage the Recovery Support Department work queue. + Maintains the WARM ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
- WellSpan Health (Mount Gretna, PA)
- …through interdisciplinary collaboration, Shared Decision Making activities including peer review . Integrate Shared Decision Making by unit committee membership or ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… more
- Healthfirst (PA)
- …the care plan for assigned members and conducts pre-certification, concurrent review , discharge planning, and case management as assigned. The Case Manager, ... Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of Centers for Medicare & Medicaid Services (CMS) or New York State + Department of Health… more
- UPMC (Pittsburgh, PA)
- …medication information and accurately enter it into the electronic chart for review by a pharmacist. Coordinate with health care professionals to facilitate any ... and resolve rejected claims, reliably coordinate multiple benefit payers, including Medicare obtaining all necessary paperwork including assignment of benefit forms.… more
- Aveanna Healthcare (Bala Cynwyd, PA)
- …are processed according to guidelines + Prepare and maintain payroll files + Review and audit weekly net profit reports and communicate discrepancies to management ... 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… more
- Penn Medicine (Philadelphia, PA)
- …regulatory requirements impacting lab operations including AABB, CMS (Center for Medicare /Medicaid Services), DOH (Appropriate state Dept. of Health), DOH (Bureau of ... in a manner which complies with all regulatory requirements; Ensures that review of department operating policies and processes are performed within required time… more
- Penn Medicine (Philadelphia, PA)
- …Department of Health (DOH), The Joint Commission (TJC) and Center for Medicare and Medicaid Services (CMS) regulations.* Effective oral and written communicator.* ... clinical integration across the system by standardizing the writing, review , updating and management of regulatory related policies. Collaborate with… more
- Penn Medicine (East Petersburg, PA)
- …joining the practices to ensure understanding current evaluation and management guidelines + Review and resolve charges in work queues based on payer edits, CCI ... + Monitors payer guidelines to ensure accurate coding, including local Medicare Administrative Contractor guidance, state payer rules, regulations, and trade… more
- Penn Medicine (Bala Cynwyd, PA)
- …**Why Choose Penn Medicine at Home?** .Accredited by the Joint Commission . Medicare and Medicaid certified .Licensed in the Commonwealth of Pennsylvania .Accept most ... therapies such as Reiki, meditation, massage and aromatherapy .PMAH provides CHPN exam review 4 x year for preparation for the Hospice and Palliative Care Nurse… more