- Molina Healthcare (UT)
- …health plan Operational Excellence teams * Ensures appropriate alignment within the program with organizational Operational Excellence programs * Manages the ... of a business process improvement capability. **Knowledge/Skills/Abilities** * Defines program scope, establish approach for implementation and maintains program… more
- Molina Healthcare (Orem, UT)
- …performance indicators (KPI's) with multiple targets depending on Medicare Program and State requirements. **Job Qualifications** **Required Education** Associate's ... Claim Experience. **Required Experience** * 7 years' experience in healthcare claims review and/or Provider appeals and grievance processing/resolution, including… more
- Molina Healthcare (Salt Lake City, UT)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... Medicare) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare Administration, etc. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Board Certification… more
- Kyndryl (Salt Lake City, UT)
- …as a strategic partner. + Bring consulting experience-preferably in the Healthcare space-to tailor engagements that resonate with industry-specific needs and ... new and existing clients by leading Digital Workplace-focused transformation programs , services and implementations centered on Collaboration, Virtualization, Contact… more
- Molina Healthcare (West Valley City, UT)
- …by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that ... related compliance functions-hands-on with CMS CTM portal, SLA tracking, and program audits. * Deep knowledge of Medicare regulations affecting complaints,… more
- Molina Healthcare (Provo, UT)
- …Team. Responsible for the monitoring and intelligence, incident response, and investigations programs which are in place to avoid business disruption, threats to ... the enterprise. + Oversees and delivers tactical, operational 24x7x365 programs for enterprise protection services including physical security, crisis management… more
- Molina Healthcare (Layton, UT)
- …delegation oversight committees. * Liaison to Special Investigative Unit regarding program integrity and oversight cost expenditure. * Monitor internal compliance of ... Corporate Operations units via establishment of an internal compliance program , including annual, periodic, focal, etc. audits. * Request, review and perform… more
- Molina Healthcare (West Valley City, UT)
- …processes are established. Develops and performs internal audits/risk assessments, monitoring program for Molina Healthcare departments. Provides post audit ... standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services.… more
- Molina Healthcare (Salt Lake City, UT)
- …of Medicare experience **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, including ... Duals, Appeals & Grievances, Provider Disputes (Par and Non-Par) and overall Medicare program knowledge. * Experience reviewing all types of medical claims (eg HCFA… more
- Intermountain Health (Murray, UT)
- **Job Description:** Organization Profile Intermountain Health is a top ranked model healthcare system whose mission is Helping People Live the Healthiest Lives ... in a healing environment, over an expansive and strategic geography. Serving the healthcare needs of people across the Intermountain West - primarily in Utah, Idaho,… more