- Highmark Health (Harrisburg, PA)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Harrisburg, PA)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- CVS Health (Harrisburg, PA)
- …we do it all with heart, each and every day. **Position Summary** The Health Service Manager -Policy Writer for Medicaid is a key member of the Medical Policy & ... Program Solutions Team. The Medicaid Medical Coding Policy Writer is an individual contributor...compliance with healthcare regulations and policies for state Medicaid and Duals line of business as it related… more
- Prime Therapeutics (Harrisburg, PA)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- Prime Therapeutics (Harrisburg, PA)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Deloitte (Harrisburg, PA)
- …federal, state, and local government agencies. Work you'll do As a Project Delivery Manager in the GPS Customer HST group you will: + Collaborate with Development ... testing, infrastructure upgrades, and integration with other DHS systems (eg, Medicaid , SNAP, TANF). + Streamline Operations:Partner with internal database teams to… more
- Gentiva (York, PA)
- …who make a lasting difference in people's lives every day. **Overview** **RN - Clinical Manager Senior - Hospice - FT - Mon-Fri - Dayshift** We're looking for a ... **Patient Care Manager Senior** to join our team. You will report...and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory… more
- Pearson (Harrisburg, PA)
- …path through this shifting environment to achieve continued success.** _Purpose Summary_ _The Medicaid and Vendor Implementation Manager will act as the main ... Pearson Virtual Schools' Connections Academy programs. Responsibilities include ensuring compliance with federal and state Medicaid regulations, optimizing… more
- Highmark Health (Harrisburg, PA)
- …related field and 3 years' experience in Acute or Managed Care/ experience with Medicaid or Medicare populations. OR + Bachelor's degree in Social Work with five ... years' experience in Acute or Managed Care/ experience with Medicaid or Medicare populations **Preferred** + CCM Certification + Experience working with high-risk… more
- Prime Therapeutics (Harrisburg, PA)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Walgreens (Camp Hill, PA)
- …growing the business at the site. Performs all duties of the Pharmacy Manager in their absence **.** **Customer Experience** + Ensures that store personnel provide ... eligibility and all required reporting and documentation. + Responsible for ensuring compliance of team members with regard to the documentation of patient… more
- Humana (Harrisburg, PA)
- …our caring community and help us put health first** The **Telephonic Nurse Case Manager ** will be a member of the Case Management Team, providing a comprehensive, ... holistic approach for case management throughout the continuum of care. The case manager will offer guidance. support, and coordination of the beneficiary's care as… more
- Humana (Harrisburg, PA)
- …our caring community and help us put health first** The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. ... The Senior Data Manager work assignments involve moderately complex to complex issues...Migration -- Planning and executing data migration projects. + Compliance -- Ensuring compliance with data protection… more
- CenterWell (Harrisburg, PA)
- …part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to ... and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require interpretation and… more
- Humana (Harrisburg, PA)
- …organization and will be critical in our growth plans. The Principal Product Manager Leads all phases of the product life cycle, from inception to introduction ... Curiosity and a human-centered approach will drive the Product Manager to find relevant data and turn it into...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Harrisburg, PA)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… more
- Prime Therapeutics (Harrisburg, PA)
- …management in the areas of problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) ... passion and drives every decision we make. **Job Posting Title** Vendor Program Manager Senior **Job Description** The Vendor Program Manager is responsible for… more
- Datavant (Harrisburg, PA)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- Humana (Harrisburg, PA)
- …organization, and will be critical in our growth plans. The Lead Product Manager - Growth & Operations will champion the customer lifecycle, drive growth ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Harrisburg, PA)
- …are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal ... veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to… more