• Medical Director -- Claims

    Humana (Harrisburg, PA)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (10/29/24)
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  • Medical Director - Florida

    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 (12/14/24)
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  • Associate Medical Director

    Lancaster General Health (Lancaster, PA)
    **Summary** **Job Description** **POSITION SUMMARY:** The Associate Medical Director , Hospitalist Services is responsible for assisting the Medical ... The Associate director will report to LGHP Medical Director and have a reporting relationship...management programs in order to ensure quality of medical care of patients at LRH and to improve… more
    Lancaster General Health (10/14/24)
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  • Medical Director - National Medicare…

    Humana (Harrisburg, PA)
    management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
    Humana (11/08/24)
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  • Director , Medical Affairs - NYC…

    Merck (Harrisburg, PA)
    **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
    Merck (12/19/24)
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  • Director , Risk Management

    Western Digital (Harrisburg, PA)
    …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
    Western Digital (12/27/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Harrisburg, PA)
    …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (01/07/25)
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  • Director , Medicaid Trend Mitigation…

    Humana (Harrisburg, PA)
    …functions strategy. + Establishes and oversees Medicaid segment trend mitigation strategy ( claims and revenue management ) + Researches industry trends and ... part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and… more
    Humana (01/08/25)
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  • Director , Patient Financial Services…

    WellSpan Health (York, PA)
    Director , Patient Financial Services - Specialty Billing Location: WellSpan Health, York, PA Schedule: Full Time General Summary Directs, plans, organizes, and ... (PFS) Key Performance Indicator (KPI) goals through effective work queue management , dashboard performance monitoring, and strong employee engagement. Duties and… more
    WellSpan Health (12/31/24)
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  • Director Healthcare Economics & Trend…

    Baylor Scott & White Health (Harrisburg, PA)
    claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
    Baylor Scott & White Health (12/21/24)
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  • Actuarial Director , Medicaid Trend…

    Humana (Harrisburg, PA)
    …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
    Humana (01/03/25)
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  • Associate Director , Global Labeling Lead…

    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
    Takeda Pharmaceuticals (10/16/24)
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  • Assistant - Risk Management

    Penn State Health (Hershey, PA)
    Management to include hospital risk, professional liability, insurance and claims management . Reviews, assesses and analyzes various types of confidential ... insurance and general and professional liability. + Provides dedicated support to Director of Risk Management on special, time-sensitive, non-routine projects,… more
    Penn State Health (10/23/24)
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  • Care Management Associate

    CVS Health (Harrisburg, PA)
    …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... services -Promotes communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers, and health… more
    CVS Health (01/08/25)
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  • Reimbursement Specialist

    UPMC (Harrisburg, 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
    UPMC (12/31/24)
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  • Area Manager, Fleet Safety

    Walmart (Pottsville, PA)
    …Hygiene and Safety Technician; Safety Trained Supervisor; North American Transportation Management Institute Certified Director of Safety; North American ... Transportation Management Institute Certified safety Supervisor; Safety Management Specialist; Certified Safety Manager; Safety Director ; Licensed Safety… more
    Walmart (11/26/24)
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  • Sales Administrator

    Fujifilm (Harrisburg, PA)
    …Sales Administrator for Latin America and the Caribbean will report to the Director of Sales for ID/Optical Devices/ EID. The primary responsibility of this position ... be to support sales for Latin America and Caribbean accounts currently under management by FNAC. Achieve the division sales plan, provide weekly and monthly detail… more
    Fujifilm (01/07/25)
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  • Principal Client Solution Architect - State…

    Mathematica (Harrisburg, PA)
    …or APCD claims data; EHR and/or HIE data; healthcare informatics; medical coding). * Ability to describe difficult technical problems and solutions to a ... data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and… more
    Mathematica (01/04/25)
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  • AVP, Human Resources Business Partner

    SitusAMC (Harrisburg, PA)
    …team! This role is responsible for aligning business goals with employees and management . The position should anticipate HR needs in a proactive manner and ... communicate these requirements and potential solutions to the management team. This position is the HR point of contact for management and employees for their… more
    SitusAMC (01/04/25)
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  • Sr. Applied Stars and Quality Analytics Analyst

    Prime Therapeutics (Harrisburg, PA)
    …) experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical , and/or financial data + Basic to intermediate SAS coding ... adjust focus **Reporting Structure** + Reports to Manager or Director in the Network Management , Consulting Analytics...to Manager or Director in the Network Management , Consulting Analytics or Operations & Planning department Potential… more
    Prime Therapeutics (12/24/24)
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