- AmeriHealth Caritas (Newtown Square, PA)
- …other administrative services. Discover more about us at www.amerihealthcaritas.com . The ** Network Pricing Analyst** will collaborate with team members and ... matter experts to identify root causes of trends. + Support the Network team with validation of Medicaid/Medicare/Exchange pricing , collaborating with internal… more
- Humana (Harrisburg, PA)
- …first** Humana is a $100+ billion (Fortune 38) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As ... is committed to advancing the employment experience and vitality of the associate community. Through offerings anchored in a whole-person view of human well-being,… more
- Humana (Harrisburg, PA)
- …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... for hospitals and facilities. They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business… more
- CenterWell (Harrisburg, PA)
- …ensures contract compliance and performs analysis regarding pharmacy claims and network composition to identify contracting needs to provide adequate coverage for ... Benefits Manager (PBM), Humana Pharmacy Solutions, to maintain Humana's pharmacy network for existing and upcoming Medicaid business. The primary responsibilities of… more
- Geisinger (Danville, PA)
- …plans, or other arrangements. + Performs accounts receivable review for special pricing packages and ensures appropriate allocation of funds. + This includes the ... starting on day one + Three medical plan choices, including an expanded network for out-of-area employees and dependents + Pre-tax savings plans with healthcare… more
- CVS Health (Blue Bell, PA)
- …deep dives + Collaborate with the Plan President, Sales, Finance, Underwriting, Network , Contracting, and Product to develop the best estimate rate actions, market ... specific growth strategies while practicing pricing discipline + Partner with the Rate Review, Forecasting,...degree along with 5+ years of experience + ASA ( Associate of the Society of Actuaries) designation or FSA… more
- Penn Medicine (Philadelphia, PA)
- …program at PAH Neurology. This position is complete located at PAH, but will network with colleagues at HUP. The position will be eligible for a hybrid schedule ... authorizations and obtains prior authorizations for procedures. + Obtains medication pricing and coverage information for patients. + Initiates Tier 1 prescription… more