- Grant Thornton (Philadelphia, PA)
- As a Process Risk & Claims Audit Manager, you will get the opportunity to grow and contribute to our clients' business needs by helping them understand ... and help you achieve more, confidently. Your day-to-day may include: + Leverage claims operations experience and claim audit experience to review and analyze… more
- Sedgwick (Harrisburg, PA)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... informs management of new procedures and ideas for continuous process improvement; and coordinates with management projects for the...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- Cardinal Health (Harrisburg, PA)
- …planning, as well as the development and completion of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory ... evaluates the adequacy of management corrective action to improve deficiencies; maintains audit records. + Conducts risk assessments to define audit… more
- Ford Motor Company (Harrisburg, PA)
- …strategic decisions, or adoption of best practices . Manage internal and external audit procedures **UW Audit Process :** . Manage overall underwriting ... compliance . Lead and manage the quality/content of Underwriting audit findings and the audit process... to do so. Implement and monitor supplementary underwriter self- audit quality control processes ** Risk Management:** .… more
- Highmark Health (Pittsburgh, PA)
- …This job is responsible for development and implementation of strategic audit plans utilizing numerous inputs including contracts, industry trends and revenue ... maximization schemes. The incumbent will also work with other audit team members and external vendors to develop specific...and durable medical equipment to identify key areas of risk exposure and develop plans to mitigate risks and… more
- Otsuka America Pharmaceutical Inc. (Harrisburg, PA)
- …ready, oversee clinical trial and submission support, lead the R&D audit program, engage with regulatory authorities, and maintain clinical data integrity. ... sites, and vendors (including contract research organizations) and ensure that audit results are communicated, and appropriate corrective actions are implemented and… more
- WellSpan Health (York, PA)
- …qualified patients, drugs and locations. Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. Evaluates ... and improve 340B Program compliance and performance and for compliance and audit purposes. Maintains up-to-date policies and procedures on 340B purchasing processes.… more
- UPMC (Pittsburgh, PA)
- …has an exciting opportunity for a Physician Educator position in the HCC Risk Adjustment Department. This is a full-time position working Monday through Friday ... related to coding and documentation in the medical record and the various risk adjustment models of payment. The Physician Educator is responsible for education of… more
- Highmark Health (Harrisburg, PA)
- …to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
- Burns & McDonnell (Conshohocken, PA)
- …Negotiate prime contracts, CM contracts, subcontracts, and change orders. + Participate in risk review process . + Implement assigned sections of the Project ... client, supplier and company commissioning and startup teams as needed. + Implement, audit , and oversee project documentation. + Implement process for confirming… more