- Humana (Harrisburg, PA)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- 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 one ... Medicare and Medicaid Services to transform federal health programs. The ** Director I Medicare Operations** is responsible for directing multiple business… more
- CVS Health (Harrisburg, PA)
- …based (work at home) based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part ... 6 company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...Board Certified in ABMS Recognized Specialty **Preferred Qualifications** * Medical Management - Medicare Complaints, Grievance &… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CVS Health (Harrisburg, PA)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Double Board ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- 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...CMS compliance for inpatient rehab admissions + Participate in National medical conferences and committees as needed… more
- CVS Health (Harrisburg, PA)
- …and behavioral health programs and services to its membership. Aetna is looking for a medical director to be part of a centralized team that supports the ... related to precertification, concurrent review, and appeal request. The medical director is a work-at-home position located...Two (2) + years of experience in managed care ( Medicare and/or Medicaid) Experience with managed care ( Medicare… more
- CVS Health (Harrisburg, PA)
- …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... in both our Dually Eligible Special Needs Plan (DSNP) and our Medicare -Medicaid Plan (MMP) programs. We collaborate with members, providers, and community… 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 services for aligned plan's members. Position Description: Aetna Medicare Duals Center of Excellence is searching for a...the delivery of holistic and integrated person-centered care. The Medical Director will be responsible for provider… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Harrisburg, PA)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations,… more
- Lancaster General Health (Lancaster, PA)
- …accommodation) to perform the following duties: + Lead and develop the medical and programmatic components of Penn Medicine Advanced Home Health.. + Coordinate ... Prescribe or administer treatment, therapy, medication, vaccinations, and other medical care to treat or prevent illness, disease, or...+ A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance… 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
- 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
- Lancaster General Health (Lancaster, PA)
- …Penn Medicine brings together the strengths of a world-renowned, academic medical center and a nationally recognized, not-for-profit community healthcare system. LG ... The candidate will also perform as a CLIA lab director of various waived or moderate complexity testing sites....+ A health care provider in good standing with Medicare , Medicaid, and other federal and state health insurance… more
- Penn Medicine (Bala Cynwyd, PA)
- …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... 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 Associate Director , Agile Coaching guides, educates, and mentors organizational leaders and their teams to ... including Scrum, Kanban and Scaled Agile Framework (SAFe). The Associate Director , Agile Coaching requires a solid understanding of how organization capabilities… 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