- 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
- Select Medical (Camp Hill, PA)
- …**Inpatient Central Business Office Trainer** (on-site role) **Why work at Select Medical ?** **We are committed to your growth and success:** + Career advancement ... _Availability of benefits is dependent on role with Select Medical ._ Our team offers first-shift, Monday through Friday schedules...be involved in special projects as assigned by the Director of CBO or VP Patient Accounting. **Responsibilities** +… more
- 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
- 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
- Humana (Harrisburg, PA)
- …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Lyric (Harrisburg, PA)
- …+ Collaborates cross-functionally within a matrixed organization, specifically partnering with Medical Director staff, Clinical Content Development, Sales, and ... to ideate and evangelize new editing concepts + Validates the findings of Medical Director staff, Clinical Analysts, Analytics Advisors and addresses any… more
- Evolent Health (Harrisburg, PA)
- …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… more
- WellSpan Health (York, PA)
- Director -Patient Financial Services Specialty Billing Location: WellSpan Health, York, PA Schedule: Full Time General Summary Directs, plans, organizes, and controls ... (PFS) Key Performance Indicator (KPI) goals through effective work queue management , dashboard performance monitoring, and strong employee engagement. Duties and… more
- Lancaster General Health (Lancaster, PA)
- …built by and powered by Penn Medicine. Our approach provides full claims administration, medical management , network development/contracting, wellness, and ... administrative follow-up for problems and issues identified and led by the Medical Director . **SECONDARY FUNCTIONS:** **The following duties are considered… more
- Elevance Health (Harrisburg, PA)
- …responsibility for Program Management and/or Medicare Integrity Operations. + Program Management includes but is not limited to: Claims , Grievance & Appeals, ... ** Director I Medicare Operations** **Location:** This position will...years professional/leadership experience with CMS, including strategic planning, project management , Medicare or related healthcare insurance or medical… more
- J&J Family of Companies (Harrisburg, PA)
- …safety data, international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and implements ... Associate Director , Signal Detection Scientist - 2406212640W **Description** Johnson...position is to lead the implementation of the Signal Management Group's aggregate surveillance strategies for proactive and systematic… more
- Cardinal Health (Harrisburg, PA)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- Sumitomo Pharma (Harrisburg, PA)
- …a dynamic, highly motivated, and experienced individual for the position of ** Director , Market Access Insights** to support US Market Access strategic and tactical ... navigating complex organizational structures / experience in highly matrixed environments. The Director will be a member of the Commercial Insights team. This… more
- 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
- Evolent Health (Harrisburg, PA)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- Sedgwick (Harrisburg, PA)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director SAP Program **PRIMARY PURPOSE** **:** Directs the strategic planning, ... of SAP FICO and BRIM Solution Components, including Subscription Order Management (SOM), Convergent Charging (CC), Convergent Invoicing (CI), Contract Accounting… more
- Evolent Health (Harrisburg, PA)
- …models using healthcare data (ie, both structured and unstructured data from operations, claims , and medical charts) to solve complex problems, drive innovation, ... in everything from scrubs to jeans. **Position summary** As an Associate Director , Data Scientist (Machine Learning Engineer), you will be responsible for… more
- Prime Therapeutics (Harrisburg, PA)
- …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more
- Evolent Health (Harrisburg, PA)
- …leaders across the organization, training and development, provider relations, member services, claims management and our implementation team will also be ... plans and serves in a supporting role to the Director , Intake and Utilization Management Operations. +...population management or managed care/insurance or hospital medical management department setting may be substituted… more
- Prime Therapeutics (Harrisburg, PA)
- …value based contracts, provider accountable care organization pharmacy metrics, medical policy, utilization management , medication adherence, and medication ... learning, predictive modeling, and reporting for complex pharmacy and medical health insurance clinical programs and services (eg, pharmaceutical manufacturer… more