- Evolent (Harrisburg, PA)
- …MD provider is recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Penn Medicine (Philadelphia, PA)
- …a particular focus on Pennsylvania, New Jersey, and Delaware. Reporting to the Senior Director of Government Relations and Regulatory Affairs, the Associate ... the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and...advocacy priorities. + Serves as an advisor to the Senior Director of Government Relations and Regulatory… more
- Baylor Scott & White Health (Harrisburg, PA)
- … senior leadership, hospital senior leadership, and senior medical staff including denials from all payers, Medicare /Medicaid audit activities and key ... **Job Summary** The Director , Denial Resource Center is responsible for the...improved utilization of appropriate patient care services. Collaborates with medical , clinical, HIM and other BSWH departments to ensure… more
- Organon & Co. (Plymouth Meeting, PA)
- **Job Description** **The Position** The Regional Payer Account Director (RPAD) reports directly to the Executive Director , Regional Payer Accounts. The RPAD ... and programs. The primary customer/account responsibilities include key Regional Commercial and Medicare Health Plan accounts. The primary goal is to achieve desired… more
- CVS Health (Harrisburg, PA)
- …it all with heart, each and every day. **Position Summary** The Lead Director , Provider Portal Strategy & Operations is responsible for the strategic leadership and ... oversight of Aetna's three primary provider portal solutions: Availity Commercial/ Medicare Portal, Availity Medicaid Portal, and DentalXchange Dental Portal. This… more
- IQVIA (Wayne, PA)
- Job Description Summary: **Associate Director Finance Operations** Directs financial planning and accounting practices including budgeting, costing, financial ... financial application software is essential. Understanding of **PBM systems and Medicaid/ Medicare billing.** + **Familiarity with NCPDP standards.** + **Knowledge of… more
- CSL Behring (King Of Prussia, PA)
- …required data collection and submit all reports needed for compliance. 4. Work with Senior Director , Policy Advocacy & Government Affairs, & Legal to interpret ... **Experience** + Strong knowledge of the regulatory requirements for MDRP, Medicare /IRA, Veteran's Healthcare Act, and other Federal regulations mandating price… more
- Danaher Corporation (Philadelphia, PA)
- …commercial customer engagement and responding to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the Value ... Danaher Business System (https://www.danaher.com/how-we-work/danaher-business-system) which makes everything possible. The Senior Field Reimbursement Manager (US REMOTE) position is a… more
- Sunrise Senior Living (Haverford, PA)
- **When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will ... meaningful ways to serve, grow, and shine together.** **Sunrise Senior Living was again certified as a Great Place...Care model. + Assists with case management of both Medicare and non- Medicare guests/residents as needed. +… more
- Humana (Harrisburg, PA)
- …Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement ... company's total revenue and earnings. Team members partner with senior leaders of the business unit, and more broadly...initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the… more