- Gentiva (Wyomissing, PA)
- …sources, and the care team * Assist with referrals, regulatory documentation, and payer compliance * Travel to various Gentiva hospice locations as assigned to fill ... urgent needs **Schedule & Travel:** This role typically follows a Monday-Friday schedule, with occasional on-call responsibilities. Travel is required and may include: + Option 1: Overnight travel required to cities within a 100-mile radius. + Option 2:… more
- Trinity Health (Pittsburgh, PA)
- …+ Maintain participation in Medicare, Medicaid, and other third party payer programs as required by administration. **Skills and Qualifications** + Management ... of chronic diseases and commonly encountered outpatient acute medical conditions. + Knowledge and competencies in understanding and collaborating with the region's behavioral health and social service system. + Comfort providing above services to individuals… more
- Elevance Health (Seven Fields, PA)
- …understanding of healthcare dynamics, including service delivery, reimbursement models, and payer systems preferred. + Experience in healthcare finance or healthcare ... actuarial analytics preferred. + Substantial analytical experience in the healthcare industry preferred. + Advanced SQL & SAS skills. + Oracle Exadata experience preferred. + Familiarity with AI/ML frameworks. + Additional skills for success are Python,… more
- Cardinal Health (Harrisburg, PA)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas,… more
- Surgery Care Affiliates (Exton, PA)
- …Stakeholder Engagement + Cultivate strong physician relationships, community partnerships, and payer /employer collaborations + Act as liaison to internal boards and ... external constituents including government and healthcare organizations Qualifications + Bachelor's degree in Healthcare Administration, Business or related field required. Master's degree in Healthcare Administration, Business or related field preferred + 10+… more
- AscellaHealth (Berwyn, PA)
- …external audit processes. + Work with assigned clients to assess trends around payer responses. + Participate in the development and completion of individual and ... departmental initiatives. + Performs other related duties as assigned or as necessary; remains flexible and adaptable in work schedules and work assignments as defined by departmental and organizational needs. Necessary Skills, Education & Abilities + A high… more
- Norstella (Harrisburg, PA)
- …or expanding our solutions in long term partnerships. Solution Consultants infuse deep payer and data expertise into the sales process and they lead the capabilities ... portion of every sales engagement with a strong point of view by showcasing MMIT's offerings with use case scenarios. Solutions Consultants collaborate with our VP level sales executives in applying MMIT's solutions to pharmaceutical manufacturers, managed… more
- Acxiom (Harrisburg, PA)
- …Comprehensive knowledge and deep understanding of the Healthcare industry including payer , provider and life science. Possess specialized insights, and a nuanced ... understanding of the market dynamics, trends, challenges, regulations, and competitive landscape. **DUTIES AND RESPONSIBILITIES:** + Achieves and exceeds revenue growth targets, maintains revenue run rate, profitability targets, and other sales related goals… more
- Cognizant (Harrisburg, PA)
- …ensure accurate and timely adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client ... issues related to claims adjudication and adjustments. Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the employer's plan document. You will be valued member of the Cognizant team and collaborate with… more
- Sumitomo Pharma (Harrisburg, PA)
- …SHA, MMIT/DRG formulary / market access data). + Solid understanding how brand payer access impacts sales strategy and field pull through tactics. + Proven success ... in developing analyses with Business Intelligence tools and methods (eg, Tableau, Qlikview, SQL). + Excellent team player and collaborative skills. + Strong demonstrated project management skills and managing external vendors/ deliverables within tight… more