• Associate Director , Provider

    Evolent (Harrisburg, PA)
    …Account teams and payer clients to align priorities and deliver high-quality provider network engagement, performance reporting, and present to health plans ... OR THE SOUTHWEST REGION We are seeking a strategic and collaborative Associate Director , Provider Engagement to lead our oncology-focused provider engagement… more
    Evolent (07/25/25)
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  • Ld Director , Medicaid Provider

    CVS Health (Harrisburg, PA)
    …do it all with heart, each and every day. **A Brief Overview** The Lead Director , Provider Data Compliance is responsible for overseeing the compliance of ... readiness and collaborates with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure...+ A minimum of 2 years of experience in provider data management and contracting support. +… more
    CVS Health (08/20/25)
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  • Service Now Director , IT Business…

    St. Luke's University Health Network (Allentown, PA)
    …serve, regardless of a patient's ability to pay for health care. The Director , IT Business Management /Operations, Service Now provides operational oversight and ... Technology processes and resources. Develops long and short-term strategies to support Network Operations for IT Systems supporting the applications in their domain.… more
    St. Luke's University Health Network (08/14/25)
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  • Director Financial Investigations…

    Highmark Health (Pittsburgh, PA)
    …by audits, vendor audits and analysis activities, (c) actively communicating with management from various departments regarding impact on provider relations and ... key liaison to external professionals serving on the MRC; prepares and presents provider / network appeal cases; and/or providing technical expertise in… more
    Highmark Health (08/08/25)
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  • Director , Quality and Risk…

    St. Luke's University Health Network (Orwigsburg, PA)
    …we serve, regardless of a patient's ability to pay for health care. The Director , Quality and Patient Safety is responsible for all aspects of Quality, Clinical Risk ... Management and Patient Safety for their assigned entity. This...changes to enhance patient safety, and collaborate with the network partners to enhance the delivery of quality and… more
    St. Luke's University Health Network (08/08/25)
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  • Lead Director ; Actuarial - Medicare…

    CVS Health (Blue Bell, PA)
    …at a market level-data cubes, HCIC (health care information center), curation of a network , and overall provider performance. + Participate in state specific RFP ... day. **Position Summary** Aetna is recruiting for a Lead Director , Actuarial - Medicare who will be responsible for...be responsible for understanding and driving action on Medicare Network Insights and curating support for this important line… more
    CVS Health (07/31/25)
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  • Director , Retail Pharm Network

    UPMC (Pittsburgh, PA)
    **Purpose:** The Director , Retail Pharmacy Network is responsible, as part of a team effort, in the planning, organizing, and directing the legal, professional, ... administrative, and financial functions of the UPMC Retail Pharmacy Network . This network includes the UPMC hospital-based pharmacies and the UPMC central fill… more
    UPMC (07/27/25)
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  • Medical Director Utilization…

    AmeriHealth Caritas (Philadelphia, PA)
    …their providers: + Identifying and implementing evidence-based practice guidelines throughout the provider network . + Overseeing the quality of clinical care for ... ; **Responsibilities:** The Medical Director , Utilization Management provides organizational leadership... and non- network providers. + Engaging the provider network in Continuous Quality Improvement through… more
    AmeriHealth Caritas (08/12/25)
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  • Operations Management Executive…

    CBRE (Philadelphia, PA)
    Operations Management Executive Director - Life Sciences Sector Job ID 232208 Posted 06-Aug-2025 Service line GWS Segment Role type Full-time Areas of Interest ... States of America Position is equivalent to a Sector Director Job Summary: The Operations Management Executive...Build and maintain a robust internal and external talent network to secure a strong bench. + Drive high… more
    CBRE (08/08/25)
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  • Director , IT Strategy, Operations…

    Endo International (Malvern, PA)
    …helping everyone we serve live their best life. **Job Description Summary** The Director , IT Strategy, Operations, & Performance Management manages the digital ... coordinate an IT metrics program to capture and analyze data, and provide meaningful, relevant, business-focused management reporting and IT performance… more
    Endo International (08/15/25)
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