Appeals Coordinator, Health Plan - Danville, PA

Depending on assigned area of expertise the pharmacist will perform a variety of duties including performing extensive literature review for the development of criteria for management of the pharmacy benefit administering the pharmacy benefit in conjunction with the Health Plan P ...

· Depending on assigned area of expertise, the pharmacist will perform a variety of duties. · ...

Provides support in administration of the Appeals and Grievance process. Serves as a liaison between Members and the Plan with appeals regarding denied claims/services, referrals, membership and benefit issues and concerns regarding quality of care or service. · ...

We are seeking a highly skilled and detail-oriented Senior Underwriter– serving as an individual contributor- with strong expertise in Administrative Services Only (ASO), Stop Loss, and Pharmacy risk evaluation and pricing to join our dynamic team. · ...

Supports the daily operations associated with the Health Plan's Actuarial Department. Assists in the development of rate filings, trend analysis, revenue strategy, forecasting, reserving, data management and analytics. Monitors the impact of strategic initiatives regulatory refor ...

We are seeking a highly skilled and detail-oriented Senior Underwriter with strong expertise in Administrative Services Only (ASO), Stop Loss, and pharmacy risk evaluation to join our dynamic team. · ...

We are seeking a highly skilled and detail-oriented Senior Underwriter– serving as an individual contributor- with strong expertise in Administrative Services Only (ASO), Stop Loss, and Pharmacy risk evaluation and pricing to join our dynamic team. · ...

Supports the daily operations associated with the Health Plan's Actuarial Department. Assists in the development of rate filings, trend analysis, revenue strategy, forecasting, reserving, data management and analytics. · ...

Supports the daily operations associated with the Health Plan's Actuarial Department. · ...

Geisinger Health plan is hiring a Licensed Regional Sales Representative. This is a field-based position, whereby you become the face of Geisinger throughout the assigned region. · ...

+Job summary:Geisinger Health plan is hiring a Licensed Regional Sales Representative. · This is a field-based position whereby you become the face of Geisinger throughout the assigned region. · +Responsibilities:Assists in the development of short-term and long-term regional sal ...

Geisinger Health Plan is now hiring full-time Customer Care Associates for our April /6/2026) training class. If you are looking for an opportunity to begin a career in healthcare where you can grow not only in our health plan but also Geisinger health system, please apply. · ...

+Job Summary · Geisinger Health Plan is now hiring full-time Customer Care Associates for our April training class.If you are looking for an opportunity to begin a career in healthcare where you can grow not only in our health plan but also Geisinger health system, please apply. ...

Manages day to day operations of Program Integrity Department Ensures compliance with all federal state and other regulations while maintaining the integrity of all auditing data and reports Conducts periodic compliance and performance reviews of auditor cases and activity Improv ...

Job Summary · The Provider Engagement Specialist supports the Provider Engagement team in driving value-based care initiatives, strengthening provider relationships, and improving operational performance across home health, private duty nursing, and shift care programs. This role ...

This role provides leadership and/or business and technical oversight of assigned configuration segments within the organization. · Identifies best practices for service offerings for all areas of configuration. · Acts as the business liaison for IT for software upgrade managemen ...

Provides leadership and/or business and technical oversight of assigned configuration segments within the organization. · ...

Job Summary · The Provider Engagement Specialist supports the Provider Engagement team in driving value-based care initiatives, strengthening provider relationships, and improving operational performance across home health, private duty nursing, and shift care programs. This role ...

Assists in resolving customer concerns, providing appropriate education/instruction and maintaining customer satisfaction by providing the highest level of customer service in only one of the Primary Functions (enrollment, claims or phones). · ...

Provides training and process improvement efforts across the clinical practices for the development of consistent and comprehensive clinical practices supported by the Health Plan. · ...