- Trinity Health (Philadelphia, PA)
- …for a Lead Patient Access Representative to join our ED team ! **Schedule:** Full Time, 40hrs/wk evening shift 3p-11p. Expectations for flexibility to cover ... system + Medical terminology and insurance knowledge + Experience with insurance eligibility systems including Medicaid , Medicare, and other commercial and… more
- Guthrie (Sayre, PA)
- …management of: + Centralized prior authorization and financial clearance units + Medicaid eligibility and enrollment assistance teams + Ensure consistent ... registration functions across The Guthrie Clinic. This role leads the central authorization team and corporate Medicaid enrollment team . This role ensures… more
- WellSpan Health (York, PA)
- …for qualified patients, drugs and locations. Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. ... Evaluates patient eligibility for qualified and non-qualified patients in mixed-use areas...patients, drugs, and locations. - Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate… more
- Amgen (Pittsburgh, PA)
- …Rare Disease- we reach millions of patients each year. As a member of the Amgen team , you'll help make a lasting impact on the lives of patients as we research, ... within them, you'll thrive as part of the Amgen team . Join us and transform the lives of patients...products are covered under the benefit design (Commercial, Medicare, Medicaid ) + Serve as a payer expert for defined… more
- Elevance Health (PA)
- …modalities to patients who receive home and community-based services through state Medicaid programs, dual eligible members and other membership as assigned by our ... and psychosocial needs with support and input from the company's inter-disciplinary team . + Educates patients and families about medication usage, side effects,… more
- UPMC (Camp Hill, PA)
- …in the Lycoming County area to join the Community HealthChoices team ! Community HealthChoices (CHC) is Pennsylvania's managed care long-term services and ... physical disabilities in the Commonwealth who are covered by Medicare and Medicaid . To provide service coordination services across the continuum of care through… more
- CVS Health (PA)
- …recruiting for an exciting opportunity to join it's CVS Health's leadership team as a Director, Pharmacy Benefit Management (PBM) Underwriting, Analysis and ... Strategy. In this role, you will lead a critical segment supporting a strategic PBM client...a deep understanding of PBM financial levers within Commercial, Medicaid , Medicare Part D, and Public Exchange lines of… more
- Elevance Health (Harrisburg, PA)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health...enhance quality, efficiency, and training. + Participate in all team meetings, staff meetings, and training sessions. + Assist… more
- CVS Health (PA)
- …makers at a health plan. These include the health plan's pharmacy support team , pharmacists, medical directors, CMO as well as other senior health plan leaders. ... 2 and up to 4 market segments for any particular client (Medicare, Medicaid , Exchange, or Commercial). The Health Plan Clinical Advisor is responsible for… more
- UPMC (Pittsburgh, PA)
- …Medical Assistance! Additionally, CHC is also for individuals that qualify for Medicare, Medicaid , or require a nursing facility level of care. The CHC Service ... Responsibilities: + Establish and build strong relationships with both internal team members and partner provider foster a collaborative environment. Educates on… more