- CenterWell (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Project Management Lead manages all aspects of a project, from start to finish, so that it is ... completed on time and within budget. The Project Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Project… more
- Humana (Harrisburg, PA)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. +… more
- Highmark Health (Harrisburg, PA)
- …models of care, operating within a framework highly regulated by the Centers for Medicare & Medicaid Services (CMS). Experience in quality improvement and audit ... that require cross-functional collaboration and management of interdependencies between a group of projects and/or related activities within the constraint of scope,… more
- Humana (Harrisburg, PA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage, and Medicaid requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other… more
- Humana (Harrisburg, PA)
- …internal teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid , and Medicare Advantage requirements and will ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other… more
- CenterWell (Harrisburg, PA)
- …records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program ... a part of our caring community and help us put health first** The Program Management Lead , Offshore Coding Operations conducts quality assurance audits of medical… more
- Cardinal Health (Harrisburg, PA)
- …chargebacks and vendor invoices and developing and negotiating customer and group purchasing contracts. + Demonstrates knowledge of financial processes, systems, ... getting the right things done. The Accounts Receivable Team Lead performs day-to-day AR functions with the goal of...company when necessary. + Bills supplemental insurances including all Medicaid states on paper and online. + Oversees appeals… more
- CVS Health (Harrisburg, PA)
- …in facilitating live discussions + 3+ years of experience in healthcare payor, Medicare , Medicaid or provider consulting experience + 3+ years' experience ... and improve the health of millions are endless. As Lead Director, Enterprise Strategy, you play a pivotal role...world. Our Enterprise Strategy team is a small, high-performing group that works closely with executive leadership to pave… more
- Highmark Health (Pittsburgh, PA)
- …of business: Medicaid , Federal Segments - Individual, ACA and Senior Markets, Group and Direct Pay Medicare Advantage, Direct Pay Medicare Supplemental ... manage competitive pressures. + **Product Strategy & Innovation** : Lead the development, execution, and continuous optimization of the...+ Master's Degree + 10 years of experience in Medicare / Medicaid + 10 years of experience in… more
- Gentiva (Altoona, PA)
- …**Demonstrated ability to apply hospice principles, industry standards, and regulatory compliance ( Medicare , Medicaid , JCAHO, ACHC)** We are seeking a dedicated ... **Overview** **Advance Hospice Care. Lead Clinical Excellence. Inspire Compassionate Teams.** **RN Clinical...to apply hospice principles, industry standards, and regulatory compliance ( Medicare , Medicaid , JCAHO, ACHC) + Knowledge and… more