- WellSpan Health (York, PA)
- …and institutes appropriate courses of action. + Prepares detailed appeals and attends Medicare Administrative Law Judge (ALJ) hearings as necessary for Medicare ... time off (PTO) Short-term disability Education assistance Financial education and support , including DailyPay Wellness and Wellbeing programs Caregiver support … more
- Gentiva (Pittsburgh, PA)
- …Report directly to the Executive Director or Administrator * Lead and support a high-performing hospice program, ensuring excellent care delivery and regulatory ... administrative workflows such as documentation of referrals, DME pickups, Medicare eligibility, insurance verifications, and patient benefit tracking * Coordinate… more
- Aveanna Healthcare (Pittsburgh, PA)
- …acceptable staffing levels. Ensure compliance with Nurse Practice Act Evaluate, supervise and support clinical staff. Ensure that the clinical staff are aware of any ... and procedures. Maintain third-party payor rules and regulations. Assist and support marketing efforts and maintain awareness of monthly budget. Maintain effective… more
- Humana (Harrisburg, PA)
- …Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or ... or Bachelor's degree in a related field + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage experience + Bilingual is a… more
- Evolent (Harrisburg, PA)
- …with leadership, management, and clinical staff to address complex cases and support decision-making. + Act as a key resource for Initial Clinical Reviewers, ... to the Utilization Management process, interpretation, guidelines and/or system support . + On a requested basis, may function as...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Prime Therapeutics (Harrisburg, PA)
- …identify compliance requirements, assess risks, and recommend compliant solutions that support enterprise goals + Conducts analysis to create written reports, ... Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) + Must be eligible… more
- Sunrise Senior Living (Haverford, PA)
- …follows Resident Centered Care model. + Assists with case management of both Medicare and non- Medicare guests/residents as needed. + Participates in the Care ... infection control practices. + Provides training as needed to support infection control practices. + Understands and practices the...to everyone you serve. And when combined with the support , benefits, and growth opportunities we offer, the result… more
- Penn Medicine (Lancaster, PA)
- …of practice. + CPR Certification - American Heart Association AHA Basic Life Support , formerly Healthcare Provider AHA Heart Saver AMA CPR BLS certification required ... + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance...health insurance programs, ie not excluded from participation in Medicare , Medicaid or any other federal or state health… more
- Penn Medicine (Lancaster, PA)
- …Program. + CPR Certification - American Heart Association (AHA) Basic Life Support , formerly Healthcare Provider (AHA Heart Saver AMA CPR/BLS certification required ... + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance...health insurance programs, ie not excluded from participation in Medicare , Medicaid or any other federal or state health… more
- Penn Medicine (Lancaster, PA)
- …Program. + CPR Certification - American Heart Association AHA Basic Life Support , formerly Healthcare Provider AHA Heart Saver AMA CPR BLS certification required ... + A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance...health insurance programs, ie not excluded from participation in Medicare , Medicaid or any other federal or state health… more