- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Harrisburg, PA)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- Humana (Harrisburg, PA)
- …topics to the clinical operations team and healthcare organization. The Medical Director 's work includes computer based review of moderately complex to ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...Medical Directors will learn Medicare, Medicare Advantage and Medicaid requirements, and will understand how to operationalize this… more
- Humana (Harrisburg, PA)
- …training, daily work is performed with minimal direction, but with support from other team members. The Medical Director enjoys working in a structured ... caring community and help us put health first** The Medical Director actively uses their medical...of the managed care industry including Medicare Advantage, Managed Medicaid , or other Medical management organizations, hospitals/… more
- Humana (Harrisburg, PA)
- …outcomes, consumer experiences and a highly engaged team culture **Additional Information** The medical director reports to a Lead Medical Director . ... caring community and help us put health first The Medical Director actively uses their medical...of integrity, professionalism, resourcefulness, and enjoy working in a team -based environment. Medical Directors support Humana value… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- Humana (Harrisburg, PA)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture + Knowledge and experience with national guidelines… more
- Humana (Harrisburg, PA)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture** + **Knowledge and experience with national guidelines… more
- CenterWell (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical … more
- Evolent (Harrisburg, PA)
- …meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Harrisburg, PA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management ... team . We can offer you a meaningful way to...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Evolent (Harrisburg, PA)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... team . We can offer you a meaningful way to...timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to… more
- Evolent (Harrisburg, PA)
- …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... will be a key member of the utilization management team . We can offer you a meaningful way to...Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Humana (Harrisburg, PA)
- …to put those customers at the center of everything it does." The Associate Director , Sales Support oversees a team of contracting professionals. Their primary ... carriers, and how to lead and develop a high-performing team . The Associate Director , Sales Support leads...**Additional Information** **Humana Perks:** Full time associates enjoy: . Medical , Dental, Vision and a variety of other supplemental… more
- Grifols Shared Services North America, Inc (Newark, DE)
- Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global ... and services in more than 110 countries and regions. The Associate Director , Value Access Marketing & Reimbursement is responsible for developing and executing… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** The Director , Financial Planning & Analysis - Specialty analyzes and forecasts financial, economic, and ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- Baylor Scott & White Health (Harrisburg, PA)
- …dashboards and reports for senior leadership, hospital senior leadership, and senior medical staff including denials from all payers, Medicare/ Medicaid audit ... **Job Summary** The Director , Denial Resource Center is responsible for the..., Denial Resource Center will lead a highly skilled team of Registered Nurses, Certified Coding Specialists, Complex Appeal… more
- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** Associate Director of Project Management to join the Readiness and Recovery team , focusing ... experiences, drive transformation, and support enterprise goals. The Associate Director will ensure alignment of project initiatives with business objectives,… more
- Humana (Harrisburg, PA)
- …part of our caring community and help us put health first** The Associate Director of DevOps Engineering is a strategic and technical leadership role responsible for ... guiding our DevOps initiatives. You will lead a team of talented DevOps engineers, focusing on standardization, building partnerships with software delivery teams to… more