- 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
- 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
- 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
- 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
- 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
- CenterWell (Lancaster, PA)
- …and objectively, in consultation with the Human Resources Department and the Executive Director / Director of Operations . + Participates in the interviewing, ... Clinical Manage** + Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. + Conducts/delegates the assessment and… more
- Conviva (Harrisburg, PA)
- …the clinical education team and will work also closely with Coding operations team and Clinical Excellence team under the CenterWell Primary Care Organization. ... This role reports to Associate Director of coding education and has a dotted line...with the divisional clinical educator and insights from coding operations team and clinical excellence team. The training responsibilities… more
- Prime Therapeutics (Harrisburg, PA)
- …the team through the full cycle contract management processes for Commercial, Medicare Part D, Medicaid, and Health Insurance Marketplace and the provider relations ... to pharmacy clients by creating a strong interface between contact center operations and provider relations + Develop and maintain relationships with internal and… more