- Prime Healthcare (Ontario, CA)
- …team! Responsibilities This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for ... across all aspects of the Employee Health Plans. The VP of Health Plan Operations and Claims will provide strategic leadership and development of the… more
- McLaren Health Care (Flint, MI)
- McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking ... and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP… more
- Henry Ford Health System (Traverse City, MI)
- …Minimum of three (3) years of leadership and/or management experience. + Familiarity with health plan operations and federal and state regulations. + ... to provide expertise, knowledge and recommendations for seamless daily operations . Bring concerns and pending issues to the Director...Familiarity with a broad range of health plan options (HMO, PPO, CDHP). CERTIFICATIONS/LICENSURES… more
- BayCare Health System (Clearwater, FL)
- …protocols. + Requires deep understanding of gap closure specifications. + Knowledge of health plan operations , benefit coverage, and claims processing. + ... in office required Equal Opportunity Employer Veterans/Disabled **Position** Grievance Specialist- Health Plan **Location** Clearwater:Park Place | Business and… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …transformation, technology implementations, or operational redesign programs + Deep understanding of health plan operations including benefits design, claims ... our academic community. **Description** **Architect the Future of Healthcare Delivery** Emory Health Plan seeks a visionary transformation leader to orchestrate… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …fiscal discipline + Lead annual budgeting, forecasting, and scenario planning for $1.3B health plan operations + Serve as principal financial advisor ... of our academic community. **Description** **Transform Healthcare Finance at Scale** Emory Health Plan seeks an exceptional finance leader to architect and… more
- Sharp HealthCare (San Diego, CA)
- … plan initiatives. Co-chairs SHP-ISD Governance Committees, as appropriate with health plan operations leaders.Communicates project status, targets, ... in the support of health plan information systems that enhance health plan business operations and that further the system integration of the Sharp… more
- Two95 International Inc. (Atlanta, GA)
- … Care Management, Computer Science, or related field * 10+ years of experience in health plan operations including but not limited to enrollment, finance, ... Job Title: Director, Health Plan Analytics Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Position Summary: As… more
- Centene Corporation (Queens, NY)
- …NCQA, HIPAA, and other regulatory bodies. + Oversee implementation and optimization of health plan operations systems (eg, claims adjudication platforms, CRM ... Centene is transforming the health of our communities one person at a...everything for our 28 million members. **Position Purpose:** Oversee operations , procurement opportunities, new product implementations and initiatives for… more
- Northwell Health (New York, NY)
- **Req Number** 173504 Job Description The AVP for Health Plan Performance will be responsible for driving the performance of our network solution across ... coordination and administration of policies, services and programs that optimize health plan performance for Northwell Direct. Collaborates with leadership… more