- AmeriHealth Caritas (Harrisburg, PA)
- **Responsibilities:** The Behavioral Health Member Services Specialists are responsible for PerformCare's intake processes. They are the first point of ... We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services , behavioral health services , and other… more
- CVS Health (Harrisburg, PA)
- …- 5:00pm * Provides comprehensive support and service to behavioral health clinical teams in support of member engagement and to facilitate delivery of ... typing into the computer **Required Qualifications** * 2 years Behavioral Health care experience. * Previous Customer Service experience. * Position requires… more
- Penn State Health (Harrisburg, PA)
- …in Camp Hill. Our team is working closely with the Holy Spirit Medical Center Behavioral Health team and the Penn State Health Department of Psychiatry ... OF POSITION:** The Licensed Practical Nurse is an essential member of the health care team who...outlaw discrimination._ **Position** LPN Licensed Practical Nurse II - Behavioral Health Child 1 **Location** US:PA:Harrisburg |… more
- Penn State Health (Harrisburg, PA)
- …our regional community, we completed a programmatic expansion of our child mental and behavioral health services including operating an inpatient child unit, ... PA** **About the Position:** The Department of Psychiatry and Behavioral Health for Penn State College of...general and specialty outpatient programs for children and adults. Services through Penn State Health Milton S.… more
- Health Advocates Network (Harrisburg, PA)
- …as related to the position need: long term care, acute care setting, behavioral health setting, drug and alcohol setting, managed care, quality ... Three years of professional experience with medical assistance (MA), health care services , or human services...quality, quantity, adequacy, and compensability of medical care and services rendered by service providers under the… more
- UPMC (Camp Hill, PA)
- …for the Member to provide for seamless coordination between physical, behavioral , and support services . Ensures compliance with all state and federal ... UPMC Health Plan is looking for Service ...environment. Educates on and coordinates community resources, emphasizing medical, behavioral , and social services . + Manages an… more
- Highmark Health (Harrisburg, PA)
- **Company :** Highmark Health **Job Description :** **Job Summary** This job is responsible for providing analytical support to HR Operations Shared Services ... considered for this role.** **Essential Responsibilities** Support the HR Operations Shared Services Administration team and Centers of Excellence Team in one or… more
- Highmark Health (Harrisburg, PA)
- …design, development, execution, dissemination and interpretation of clinical and population health analyses, metrics and reports using clinical, member , ... **Company :** Highmark Health **Job Description :** Applicants must be authorized...outcomes from and quality of care received, and optimal member /patient and provider experiences with care delivery. The intern… more
- CVS Health (Harrisburg, PA)
- …for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of ... Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health . + Experience conducting health -related assessments… more
- CVS Health (Harrisburg, PA)
- …LMFT, LCSW, LCPC, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist. + 1+ years of EAP, Behavioral Health or Social Services experience. + 1+ years of crisis ... that meets risk management and regulatory requirements. + Position maintains current independent behavioral health license in good standing in the state where… more
- Highmark Health (Harrisburg, PA)
- …that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and utilizing data/analytics ... job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over a specified panel of members… more
- Highmark Health (Harrisburg, PA)
- …range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics ... professional clinical judgement to identify the right clinical intervention for each member . The incumbent will be supported by a multi-disciplinary team and will… more
- Penn State Health (Harrisburg, PA)
- …in Camp Hill. Our team is working closely with the Holy Spirit Medical Center Behavioral Health team and the Penn State Health Department of Psychiatry ... and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling. **WHY PENN STATE HEALTH PPI?** Pennsylvania… more
- Centene Corporation (Harrisburg, PA)
- …ensure level of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder needs and clinical standards + ... **Position Purpose:** Performs reviews of member 's care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical… more
- Penn State Health (Camp Hill, PA)
- …assistants, social worker, therapists, and support staff. PSH Holy Spirit Behavioral Health offers an array of services and levels of care. Penn State ... for additional information. **SUMMARY OF POSITION:** The Department of Psychiatry and Behavioral Health at Penn State Health Holy Spirit… more
- Highmark Health (Harrisburg, PA)
- …to evaluate the medical necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic peer to peer discussions ... times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will… more
- CVS Health (Harrisburg, PA)
- …experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health /Substance Abuse or Maternity/ Obstetrics experience. ... company policies and procedures. + Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health … more
- Highmark Health (Harrisburg, PA)
- …line staff guidance, ensures effective and efficient delivery of Pharmacy call center services . Serves as first line reviewer in monitoring and ensuring adherence to ... the health plan's state and federal multiple drug benefit design...medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of… more
- Highmark Health (Harrisburg, PA)
- …office site visits and medical records reviews, ensuring resolution of member /provider complaints in timely manner. + Prepare periodic reports that summarize ... from claim and/or medical record reviews to continually improve the care and service to members and coordinate with the financial recovery areas to retract erroneous… more
- Highmark Health (Harrisburg, PA)
- …are designed for clinical identification and stratification and facilitating precise member routing to in-person, telephonic, and digital outreach programs. Your ... contributions will directly impact our ability to deliver impactful member outreach. **ESSENTIAL RESPONSIBILITIES** + Work with customers, Software Engineers,… more