- Humana (Harrisburg, PA)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Harrisburg, PA)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Humana (Harrisburg, PA)
- …2 who initiates, negotiates, and executes physician, hospital , and other provider contracts and agreements related to Medicaid health plans. The ... and independent determination of the appropriate courses of action. The Provider Contracting Professional 2 responsibilities include (but not limited to): +… more
- Humana (Harrisburg, PA)
- …executing upon said strategy. Communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and ... responsibility for developing contracting methodologies and foster relationships with large hospital systems. Maintains metrics and health quality based goals to… more
- Centene Corporation (Harrisburg, PA)
- …experience. 4+ years of contracting, contract analysis, provider relations, or provider experience in a hospital or physician's office/group setting. Working ... fresh perspective on workplace flexibility. **Position Purpose:** Recruit physician, hospital and ancillary service providers to sign network participation… more
- Gentiva (Shamokin Dam, PA)
- …hospice agency promptly if unable to complete F2F visits as scheduled. + May provide F2F coverage for multiple provider numbers with approval. **About You** ... physicians, interdisciplinary group (IDG) members, patients, caregivers, and families. + Provide clinical recommendations to the IDG based on F2F assessment… more
- Penn State Health (Hershey, PA)
- …Center, Level 1 Regional Adult and Pediatric Trauma Center, and Tertiary Care Provider . As a four-time Magnet-designated hospital , Hershey Medical Center values ... grievances as defined by the Centers for Medicare and Medicaid Services (CMS) and as regulated by the Department...to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in… more
- UPMC (Harrisburg, PA)
- …services. UPMC Harrisburg received a five-star rating from the Centers for Medicare and Medicaid Services Overall Hospital Quality Star Ratings for 2024, one of ... Osteopathic in Harrisburg, PA!** We are an acute care hospital licensed for 177 beds. World-class cancer care from...is a leader in providing life-changing medicine. Let us provide you with a life-changing career, including a competitive… more
- UPMC (Harrisburg, PA)
- …services. UPMC Harrisburg received a five-star rating from the Centers for Medicare and Medicaid Services Overall Hospital Quality Star Ratings for 2024, one of ... is a leader in providing life-changing medicine. Let us provide you with a life-changing career, including student loan...hours, 80 hours, or 120 hours. + Professional dues reimbursement + Reimbursement of Pennsylvania license renewal… more
- Humana (Harrisburg, PA)
- …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... guidelines. Applies clinical experience when conducting chart reviews of hospital and facility billing. Understands department, segment, and organizational strategy… more