- Select Medical (Camp Hill, PA)
- …**Inpatient Central Business Office Trainer** (on-site role) **Why work at Select Medical ?** **We are committed to your growth and success:** + Career advancement ... _Availability of benefits is dependent on role with Select Medical ._ Our team offers first-shift, Monday through Friday schedules...be involved in special projects as assigned by the Director of CBO or VP Patient Accounting. **Responsibilities** +… more
- Humana (Harrisburg, PA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Harrisburg, PA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- CVS Health (Harrisburg, PA)
- …clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health plan Sr Leadership to ... and appeal system. + Leads the administration of all medical management activities of the aligned Plans....the delivery of holistic and integrated person-centered care. The Medical Director will be responsible for provider… more
- Humana (Harrisburg, PA)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director reviews cases of diverse scope and complexity ranging...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical /surgical utilization management review experience + Experience… more
- Lyric (Harrisburg, PA)
- …+ Collaborates cross-functionally within a matrixed organization, specifically partnering with Medical Director staff, Clinical Content Development, Sales, and ... to ideate and evangelize new editing concepts + Validates the findings of Medical Director staff, Clinical Analysts, Analytics Advisors and addresses any… more
- Norstella (Harrisburg, PA)
- …will be pivotal in integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health ... Senior Director , RWD Analytics and Innovation Company: Citeline Location:...of data and intelligence on clinical trials, drug treatments, medical devices and what's new in the regulatory and… more
- WellSpan Health (York, PA)
- Director -Patient Financial Services Specialty Billing Location: WellSpan Health, York, PA Schedule: Full Time General Summary Directs, plans, organizes, and controls ... (PFS) Key Performance Indicator (KPI) goals through effective work queue management , dashboard performance monitoring, and strong employee engagement. Duties and… more
- J&J Family of Companies (Harrisburg, PA)
- Director , Health Economics and Market Access - Robotics and Interventional Solutions - 2406204289W **Description** Johnson & Johnson is recruiting a Director , ... and profoundly impact health for humanity. Learn more at https://www.jnj.com/. The Director , Health Economics & Market Access for the Robotics and Interventional… more
- Cardinal Health (Harrisburg, PA)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- Takeda Pharmaceuticals (Harrisburg, PA)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Evolent Health (Harrisburg, PA)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- Norstella (Harrisburg, PA)
- Director , RWD Product Company: MMIT Location: Remote, United States Date Posted: Jul 15, 2024 Employment Type: Full Time Job ID: R-440 **Description** Why Norstella? ... assess market potential, and inform strategic decision-making. + Translate product management strategy into actionable data deliverables, guiding development of data… more
- Evolent Health (Harrisburg, PA)
- …LPCs, and Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Associate Director and Director ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- UPMC (Carlisle, PA)
- …from medical records to provide accurate and timely information for billing, medical necessity, and reimbursement. + Works with Director of Payer Relations ... + Prepares specific financial reports as assigned. + Insurance Account Management : + Researches rejections and investigates problems, resubmitting and/or appealing … more
- Prime Therapeutics (Harrisburg, PA)
- …experience conducting complex analysis on enterprise level data sets of pharmacy, claims , medical , and/or financial data + Extensive experience with analytic ... to create new business insights related to total cost management , products and services and drives recommendations for improvements...to adjust focus **Reporting Structure** + Reports to Manager, Director or Senior Director in the Consulting… more
- Prime Therapeutics (Harrisburg, PA)
- …(such as PMPM, generic utilization) + Experience working with large sets of pharmacy, claims , medical , and/or financial data + Previous experience in a client ... adjust focus **Reporting Structure** + Reports to a Sr Professional, Manager, or Director in the Network Management , Consulting Analytics, Operations & Planning… more
- WellSpan Health (York, PA)
- …different entities. - Reviews and conducts QA checks on the applications prior to medical director 's review. - Reattests provider information every 120 days in ... Summary Maintains close communication with providers, practice managers and the medical staff office to ensure timely initial credentialing, recredentialing and… more