- Elevance Health (Harrisburg, PA)
- ** Director I Medicare Operations ** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of ... and Medicaid Services to transform federal health programs. The ** Director I Medicare Operations ** is responsible for directing multiple business function… more
- Humana (Harrisburg, PA)
- … Director is responsible for behavioral health care strategy and/or operations . The Behavioral Health Medical Director work assignments involve moderately ... requires an in-depth evaluation of variable factors. The Behavioral Health Medical Director actively uses their medical background, experience, and judgement to make… more
- Lancaster General Health (Lancaster, PA)
- **Summary** **Job Description** **POSITION SUMMARY:** The Associate Medical Director , Hospitalist Services is responsible for assisting the Medical Director , ... Services of Lancaster General Health Physicians (LGHP) Hospitalists Program, overseeing operations and clinical quality for the consultative services and on-call… more
- Aveanna (York, PA)
- Clinical Director - Registered Nurse ApplyRefer a FriendBack Job Details Requisition #: 197355 Location: York, PA 17402 Category: Clinical Care and Support Salary: ... Starting at $90,000.00 per year Position Details Position Overview The Clinical Director is responsible and accountable for managing all clinical operations .… more
- CVS Health (Harrisburg, PA)
- …integrating CVS assets to bring accessible healthcare to our members. The LTSS Director , Clinical Health Services ( Director ), will partner closely with the LTSS ... Director , Market CEO, DSNP Senior Leadership Clinical Health Services, Centers for Medicare and Medicaid Services, and State Agencies to build a transparent and… more
- Lake Erie College of Osteopathic Medicine (Erie, PA)
- Assistant Director of Patient Care Services Overview Date Posted: 8/6/2024 Location: LECOM Erie Dental Clinic Address: 2000 West Grandview Boulevard City: Erie ... Education Employment Status: Full-time Description JOB SUMMARY: The Assistant Director of Patient Care Services works with the ...the clinic; + Interface with IT staff on computer operations ; + Become proficient in axiUm software and train… more
- Cardinal Health (Harrisburg, PA)
- …team is passionate about helping oncology practices navigate the future. The Director , Managed Care is responsible for strategy and management of managed care ... responsible to implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing… more
- Penn Medicine (Bala Cynwyd, PA)
- …co-management program (PIC) in partnership with the Department of Psychiatry. The Director is responsible for the operations , performance improvement and ... Hospice- 150 Monument Road** **Hours: Per Departmental Needs** Summary: + The Director , Penn Partners in Care (PPiC) skillfully and strategically leads care… more
- Humana (Harrisburg, PA)
- …of our caring community and help us put health first** The Director , Broker Digital Sales (Innovation Portfolio Strategy) utilizes ideas, identifies innovation ... opportunities, and translates ideas into actionable and profitable business. The Director , Innovation Portfolio Strategy requires an in-depth understanding of how… more
- Humana (Harrisburg, PA)
- …Medical Director responsible for behavioral health care strategy and/or operations . The Behavioral Health Medical Director work assignments involve ... Reporting Relationship: This position reports directly to the Cluster Lead Medical Director . **Use your skills to make an impact** **REQUIREMENTS:** + Doctor of… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
- Humana (Harrisburg, PA)
- …Best Places to Work, and be a part of our dynamic team as the Director of Technology Solutions. We are on a mission to revolutionize our Customer Relationship ... your chance to make a substantial impact! As the Director of Technology Solutions, you will spearhead the strategy...of IT initiatives that are vital to our business operations . Your deep understanding of organizational capabilities and your… more
- WellSpan Health (York, PA)
- Senior Director -Payor Contracting Location: WellSpan Health, York, PA Schedule: Full Time General Summary Participates in third party payor contract negotiations and ... payment rates and methods for various types of managed care payors: including Medicare , Medical Assistance, & Commercial managed care payors. + Oversees working with… more
- Guthrie (Athens, PA)
- …Three to five years of professional reimbursement experience. Medicare /Medicaid reimbursement experience required. Extensive experience working with providers ... payment audit activities with leadership staff to maximize revenue cycle operations . 3. Provides leadership skills, clear direction, and establishes priorities to… more
- LifePoint Health (Johnstown, PA)
- …be responsible for management or delegation of day to day operations including directing and planning.Formulate and implement operational strategies and initiatives ... and Conditions of Participation (COP) requirements. . Good understanding of Medicare , Medicaid, and other third-party payment systems. . Ability to critically… more
- HealthEdge Software Inc (Harrisburg, PA)
- …them: NCQA (National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other ... particularly in the Payer space, with a perspective on how health plan operations impact willingness to adopt digital transformation and innovation + 7+ years'… more
- Highmark Health (Pittsburgh, PA)
- …staff productivity. + Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as ... Care + 3 years in Budget Administration + Experience in leading Medicare Advantage risk adjustment strategies **LICENSES OR CERTIFICATIONS** **Required** + None… more
- Aveanna (Clearfield County, PA)
- Operations Specialist ApplyRefer a FriendBack Job Details Requisition #: 195865 Location: Du Bois, PA 15801 Category: Business Operations Salary: Starting at ... $20.00 per hour Position Details Position Overview The Operations Specialist is responsible for providing top level customer service to internal and external clients… more
- Prime Therapeutics (Harrisburg, PA)
- …a thorough understanding of operating infrastructure of Strategic Business Unit(s) (SBUs) operations to be able to proactively analyze and identify opportunities for ... and resolving complex problems and issues. + If supporting Medicare Part D, will be responsible for implementing CMS...focus **Reporting Structure** + Reports to Manager or Sr Director in the Finance department **Responsibilities** + 3+ years… more
- ChenMed (Philadelphia, PA)
- …mastery of: * PCP Black Belt Training and PCP Essentials * Medical Director Essentials and Center Operations * Medical Economics and Center Financial ... organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a...our care model - the center. The Senior Medical Director (SMD) will partner with the Center Director… more