• Medicaid Provider Hospital Reimbursement…

    Humana (Harrisburg, PA)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer ... and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business… more
    Humana (08/14/25)
    - Related Jobs
  • Medicaid Provider Customer Service…

    CVS Health (Harrisburg, PA)
    …+ Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/Claims Research Medicaid team. Extensive claims research ... platforms to assist providers with payment questions. + Educate provider with related information to answer the unasked questions,...a direct connection to the router (NOT Wi-Fi). We provide a 6 1/2 foot long ethernet cord, if… more
    CVS Health (08/16/25)
    - Related Jobs
  • Ld Director, Medicaid Provider Compliance

    CVS Health (Harrisburg, PA)
    …all with heart, each and every day. **A Brief Overview** The Lead Director, Provider Data Compliance is responsible for overseeing the compliance of provider ... with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure alignment with regulatory and contractual obligations.… more
    CVS Health (08/20/25)
    - Related Jobs
  • Provider Engagement and Performance…

    Magellan Health Services (PA)
    …and other value-based data. This position acts as the conduit between the provider , Magellan, and the customer(s) to ensure streamlined, consistent and supportive ... provider experience. + Act as liaison between Clinical, Quality,...Providers for support, issue resolution, and collaboration. (40%) + Provide orientation, education, training, and support to Magellan contracted… more
    Magellan Health Services (07/24/25)
    - Related Jobs
  • Advanced Practice Wound Care Provider

    Genesis Healthcare (PA)
    …weekends)! We are seeking a part-time (16-24 hours per week) wound care provider for float between our centers located in southeastern Pennsylvania (cities include ... pillars in our day-to-day operations. Responsibilities The Advanced Practice Wound Provider reports directly to the Director of Clinical Practice and/or the… more
    Genesis Healthcare (08/26/25)
    - Related Jobs
  • VP Reimbursement, Provider & Network…

    Highmark Health (Pittsburgh, PA)
    …This role is accountable for any program or strategic tactic to drive provider performance in the domains of reimbursement and network programs. Specifically, the ... (VBR) & risk programs, as well as the overall provider inventive and payment strategy. The role also leads...The role also leads the strategy and creation of provider network designs and programs. The incumbent is responsible… more
    Highmark Health (07/12/25)
    - Related Jobs
  • Senior Software Engineer - Provider Data…

    Humana (Harrisburg, PA)
    …Contract Requires US Citizenship for this Position. Overview: Join Humana Military's Provider Data Solutions team to support the TRICARE T5 contract and deliver ... work within a caring, collaborative environment. Our team works with large-scale provider data and plays a key role in processing, preparation, dissemination, and… more
    Humana (08/26/25)
    - Related Jobs
  • Provider Data Management Processor

    NTT DATA North America (PA)
    …when executed as part of an overall sourcing strategy. NTT Data is seeking a Provider Data Management Processor to join our team working remote. 100% remote Pay Rate ... $16.75/hr Responsibilities: + Analyzing and processing provider transactions in accordance with plan provisions. + Follow...3+ years of experience in a Health care processing ( Provider Data Management preferred, Claims or other Healthcare Payer/… more
    NTT DATA North America (08/23/25)
    - Related Jobs
  • Provider Data Specialist

    Intermountain Health (Harrisburg, PA)
    **Job Description:** The Provider Data Specialist performs accurate and timely abstraction, auditing, and monitoring of data from various provider information ... Enrollment, Roster Management, Kyruus, Attestations, Credentialed and Non-Credentialed providers, Provider access to Intermountain Information Systems, Radiant Logic, and… more
    Intermountain Health (08/25/25)
    - Related Jobs
  • Consulting Manager - Innosight Healthcare…

    Huron Consulting Group (Philadelphia, PA)
    …examines the intricate patient care challenges encountered by payor and provider healthcare entities to stabilize business today and create tomorrow's growth ... consulting firm, specializing in delivering strategic solutions for healthcare provider organization clients. + **Proven leadership** in engagements involving… more
    Huron Consulting Group (08/10/25)
    - Related Jobs