- Prime Therapeutics (Harrisburg, PA)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the ... beneficial or of interest to the plan + Provide clinical guidance and support for client's Health Insurance Marketplace business + Manage incoming requests for… more
- Humana (Harrisburg, PA)
- …healthcare and/or health insurance industries + Healthcare research experience + Medicare /senior consumer experience **Additional Information** To ensure Home or ... its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage… more
- CVS Health (Harrisburg, PA)
- …medical costs and provides an unmatched experience for adults on Medicare in medically underserved communities. By providing holistic, comprehensive and integrated ... the industry-leading clinical operations and population health platform to support the delivery of high quality care to the... the delivery of high quality care to the Medicare population. As a Senior Product Manager within the… more
- CVS Health (Harrisburg, PA)
- …optimize client engagement and profitability by developing pricing offers that support client retention and growth. Daily activities include monitoring financial ... and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid, Medicare Part D, and Public Exchange lines of business. + Conduct market… more
- Aveanna Healthcare (Butler, PA)
- …nights, and weekend shifts- we will work with your availability! + 24/7 Local support from operators and clinicians + Aveanna has a tablet in each patient's home ... leaves of absence, compensation, and training. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
- Actalent (Pittsburgh, PA)
- …determination. Responsibilities + Process and manage denied prior authorization requests for Medicare and Medicaid patients. + Make 30-60 outbound calls per shift to ... Medicare members, primarily elderly individuals, regarding denied medication requests....+ Review submitted documentation and gather additional information to support the appeals process. + Forward completed cases to… more
- Penn Medicine (Lancaster, PA)
- …of practice. + CPR Certification - American Heart Association AHA Basic Life Support , formerly Healthcare Provider AHA Heart Saver courses for CPR are not accepted ... + 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
- Evolent (Harrisburg, PA)
- …to the Utilization Management process, interpretation, guidelines and/or system support . + Participates in on-going training per inter-rater reliability process. ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… 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