• 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 ... caring community and help us put health first** The Medical Director actively uses their medical...in teams focusing on quality management , utilization management , case management , discharge planning… more
    Humana (10/29/24)
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  • Medical Director - Mid West Region

    Humana (Harrisburg, PA)
    medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... in teams focusing on quality management , utilization management , case management , discharge planning...on size of region or line of business. The Medical Director conducts Utilization Management more
    Humana (10/29/24)
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  • Case Manager / PRN ( RN / RT / SW / LPN )

    Select Medical (Camp Hill, PA)
    …patients. (example: ICU, step-down, med surg, vents)** + Adequate experience in an acute medical case management setting and confidence to manage and direct ... discharge planning, treatment plan management and financial management , while also completing medical record documentation.... record documentation. You will report directly to the Director of Case Management and… more
    Select Medical (10/24/24)
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  • Medical Director - Home Health…

    Humana (Harrisburg, PA)
    …and experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received ... reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical more
    Humana (11/06/24)
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  • Medical Director -Musculoskeletal…

    Evolent Health (Harrisburg, PA)
    …training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. ... Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Medical Director for the Musculoskeletal department, you will be a key member of… more
    Evolent Health (09/10/24)
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  • Director , Regulatory Medical

    J&J Family of Companies (Harrisburg, PA)
    Director , Regulatory Medical Writing (1 of 4)...countries. Remote work options may be considered on a case -by- case basis and if approved by the company. ... - 2406211847W **Description** Johnson & Johnson is currently seeking a Director , Regulatory Medical Writing. The primary location for this position is the United… more
    J&J Family of Companies (11/07/24)
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  • Part-time/Remote Medical Director

    Highmark Health (Harrisburg, PA)
    **Company :** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care ... delivery and complex case management for our community-based palliative care...leadership and guidance to the regional interdisciplinary team. The medical director collaborates clinically with the APP… more
    Highmark Health (09/24/24)
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  • Medical Director - Pharmacy Appeals

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ... (Part D & B). The Medical director work assignments involve moderately complex...or clinical group practice management + Utilization management experience in a medical management more
    Humana (11/02/24)
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  • Medical Director - Keystone Market

    CVS Health (Harrisburg, PA)
    …preferably resides in PA/DE/WV and have a PA/WV/DE License without encumbrances. In the Medical Director role you will provide oversight for medical policy ... clinical / medical programs and expand Aetna's medical management programs to address member needs...and consistent responses to members and providers. As a Medical Director you will focus primarily on… more
    CVS Health (10/19/24)
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  • Care Manager (RN) Casual - Case

    UPMC (Carlisle, PA)
    …+ Takes leadership role in concurrent denial process. Works with Care Management Director , Physician Advisor, Attending Physicians and clinical team to ... coverage for major and minor holidays. **Responsibilities:** + Reviews medical record daily to ensure patient continues to meet...+ BSN or related Bachelor's degree preferred. + Previous case management experience preferred. + Knowledge of… more
    UPMC (08/29/24)
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  • Professional Care Manager Case

    UPMC (Harrisburg, PA)
    …+ Takes leadership role in concurrent denial process. Works with Care Management Director , Physician Advisor, Attending Physicians and clinical team to ... of nursing experience required. BSN or related Bachelors degree preferred. Previous case management experience preferred. Knowledge of healthcare financial and… more
    UPMC (09/26/24)
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  • Medical Director

    Highmark Health (Harrisburg, PA)
    …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
    Highmark Health (10/23/24)
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  • Registered Nurse - RN Case Manager…

    Gentiva (Camp Hill, PA)
    …the care they need with dignity, grace, and love. **As a Hospice RN/ RN Case Manager, you will:** + Reportdirectly to the Administrator, Executive Director or ... Manager Senior and will maintain primary control and professional management of each patient. + Act as primary liaison...supportive care to the patient's family with a reasonable case load while providing a trusting and compassionate relationship… more
    Gentiva (11/06/24)
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  • Director , MedTech IBP Re-Ignite Leader

    J&J Family of Companies (Harrisburg, PA)
    Director , MedTech IBP Re-Ignite Leader - 2406221361W **Description** J&J MedTech is recruiting for a Director , MedTech Re-Ignite IBP Leader located in Raritan, ... locations! Remote work options may be considered on a case -by- case basis and if approved by the...across Commercial, Commercial Finance, and Supply Chain. Champion change management efforts to ensure smooth adoption of the re-engineered… more
    J&J Family of Companies (11/06/24)
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  • Associate Director , Strategic Sourcing,…

    Sumitomo Pharma (Harrisburg, PA)
    …dynamic, highly motivated, and experienced individual for the position of **Associate Director , Strategic Sourcing - R&D and Supply Chain/TOQ.** The Associate ... Director Strategic Sourcing R&D and Supply Chain/Technical Operations &...opportunities. They must provide active category leadership and change management support that challenges traditional spending behavior, service level… more
    Sumitomo Pharma (09/20/24)
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  • Associate Director , CMC Regulatory Affairs

    J&J Family of Companies (Harrisburg, PA)
    Associate Director , CMC Regulatory Affairs - 2406221330W **Description** Johnson & Johnson is recruiting for an Associate Director , CMC Regulatory Affairs. This ... NJ; Beerse, Belgium or Leiden, Netherlands. Remote work options may be considered on a case -by- case basis and if approved by the Company. At Johnson & Johnson,… more
    J&J Family of Companies (11/07/24)
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  • Associate Director , Thought Leader…

    J&J Family of Companies (Harrisburg, PA)
    Associate Director , Thought Leader Liaison, Neurology Rare Disease - West Coast - 2406204275W **Description** Johnson & Johnson is recruiting for an Associate ... Director , Thought Leader Liaison, Neurology Rare Disease to support...treatment education + Align with field partners such as Medical Science Liaisons on complementary initiatives with shared customers… more
    J&J Family of Companies (09/07/24)
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  • Regional Sales Director - Southern…

    Trustmark (Harrisburg, PA)
    …experts in building partnerships with customers and with our employees. Regional Sales Director - Southern California We currently have a position open the in the ... Southern California Market for a Regional Sales Director (RSD). The Regional Sales Director (RSD) for Trustmark Voluntary Benefit Solutions division increases… more
    Trustmark (09/22/24)
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  • Associate Director Regional Marketing…

    Bayer (Carlisle, PA)
    …diverse minds to make a real difference, there's only one choice.** **Associate Director Regional Marketing - Prostate - Philadelphia - Ohio Valley** **Associate ... Director Regional Marketing - Prostate - Philadelphia - Ohio...responsible for activities across five key areas, in each case , acting as a champion to deliver brand communication… more
    Bayer (11/05/24)
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  • Senior Director Architecture…

    SitusAMC (Harrisburg, PA)
    …global but act local - come join our team! Job Profile Summary As the Sr Director of the Innovation team you will be at the forefront of developing cutting edge ... of industry and/or relevant experience, typically with 2+ years in a Senior Director level role or external equivalent. + Experience with the most current… more
    SitusAMC (10/26/24)
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