• Pharmacy Benefits Program Director; HSO…

    Mount Sinai Health System (New York, NY)
    …6 years experience in the healthcare industry, with focus on Pharmacy Health Plan or Pharmacy Benefit Management . + Proven capabilities in strategic ... Therapeutics Committee. + Ensures the clinical integrity of the Health Plan pharmacy offering. + Partners with...growth. + Participate in meetings and presentations to review benefits management performance. + Act as pharmacy… more
    Mount Sinai Health System (04/28/25)
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  • Manager II Medical Management

    Elevance Health (Costa Mesa, CA)
    …and Experiences:** + BS preferred. + MS Office Suite experience preferred. + Health plan experience preferred. + Management experience preferred. + ... $180,144. Locations: California In addition to your salary, Elevance Health offers benefits such as, a comprehensive...agreement), medical, dental, vision, short and long term disability benefits , 401(k) +match, stock purchase plan , life… more
    Elevance Health (06/06/25)
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  • Director, Pharmacy Operations & PBM…

    Premera Blue Cross (Mountlake Terrace, WA)
    …+ Ten years' experience [eight (8) years' experience with Pharmacy degree] in a large health plan , medical management or pharmacy management organization ... plan in the Pacific Northwest, we provide comprehensive health benefits and services to more than...100 companies. Our services include innovative programs focused on health management , wellness, prevention, and patient safety.… more
    Premera Blue Cross (03/14/25)
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  • Sr. Specialist, Quality Program Management

    Molina Healthcare (Scottsdale, AZ)
    …Work, or related field + 2 years of medical record abstraction experience + 1 year health plan quality management + Ability to work across all levels of ... communication skills, both verbally and written + Ability to interact effectively with health plan clinical leaders and peers across the organization +… more
    Molina Healthcare (05/09/25)
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  • Reimbursement Economics Analyst

    Highmark Health (Dover, DE)
    …are identified and executed in a timely manner. This will require engagement with Health Plan Management (SVPs, VPs, Directors, etc.) in formal and ... objectives. + Help develop and implement improved infrastructure and processes to provide Health Plan and Enterprise management with regular performance… more
    Highmark Health (04/10/25)
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  • LTSS Care Coordination (Dir GBD Special Programs)

    Elevance Health (Cincinnati, OH)
    …support the broader organizational mission and NCQA standards. + Oversee all health plan medical management programs, including person-centered planning, ... discharge planning, case management , disease management , quality management , and health ...agreement), medical, dental, vision, short and long term disability benefits , 401(k) +match, stock purchase plan , life… more
    Elevance Health (06/05/25)
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  • Manager II GBD Special Program

    Elevance Health (Miami, FL)
    …not limited to: + Directs and oversees program operations in support of corporate and health plan UM management . + Directs and collaborates with functional ... Healthcare Plans, Inc. is a proud member of Elevance Health 's family of brands. We are a licensed ...agreement), medical, dental, vision, short and long term disability benefits , 401(k) +match, stock purchase plan , life… more
    Elevance Health (06/02/25)
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  • Mental Health Parity Clinical Analyst…

    WTW (Boston, MA)
    …dealing with health and welfare plans, ideally gained in a benefit consulting/brokerage firm, Health Plan , Third Party Administrator, Regulatory ... Health analytics experience preferred + Understanding of health plan utilization/case management processes,...also eligible for an annual short-term incentive bonus. **Company Benefits ** WTW provides a competitive benefit package… more
    WTW (04/08/25)
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  • Medical Director - Medicaid (IL)

    CVS Health (Springfield, IL)
    …This is a regional role that primarily supports the Aetna Better Health Plan of Illinois. This UM (Utilization Management ) Medical Director will be a "Work ... Independent Review Organization a Plus **Preferred Qualifications:** -Preferred Illinois residency - Health plan /payor Utilization Management / Review… more
    CVS Health (06/04/25)
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  • Medical Director (ABH-WV)

    CVS Health (Charleston, WV)
    …or working for an Independent Review Organization a Plus **Preferred Qualifications:** - Health plan /payor Utilization Management / Review experience. ... Emergency Medicine, Internal Medicine-Pediatrics Specialty Preferred. - Prior UM experience working at Health Plan / Insurer or experience as a Physician Advisor… more
    CVS Health (04/30/25)
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