- CVS Health (Hartford, CT)
- …manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations . The PSL role has responsibility ... manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations . The Plan Sponsor Liaisons serve as… more
- Sea Mar Community Health Centers (Seattle, WA)
- …designation of priority objectives for the Home Health Division. + Develop the Home Health plan for clinical operations and provide for efficient use of ... community. Essential Duties and Responsibilities: + Planning: + Develop the Home Health Division plan for clinical operations and provide for efficient use… more
- CareFirst (Washington, DC)
- …strategy to execution. This position will report to CareFirst BlueCross BlueShield Community Health Plan - Chief External Operations Officer. **ESSENTIAL ... market expansion + Lead day-to-day operations of the Healthy DC Plan Basic Health Plan in DC. + Develop and oversee day-to-day operations for… more
- Highmark Health (Oklahoma City, OK)
- …and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations . **ESSENTIAL RESPONSIBILITIES** + Perform management ... business. This will require aligning new models to the health plan 's strategic objectives based on a...Plan , organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and… more
- Highmark Health (Columbus, OH)
- …sales narratives and messaging for our products, networks, reimbursement, clinical services, UM, and health plan operations in a powerful and compelling way ... RESPONSIBILITIES** + Collaborate with matrixed partners to define and refine Highmark Health Plan 's sales narratives in a compelling way that establishes… more
- Point32Health (Canton, MA)
- …strong consultative skills. + Working knowledge of both the medical and business side of health plan and provider operations . + Ability to understand and ... members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan...**Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible for the department's… more
- CVS Health (Chicago, IL)
- … insurance experience preferred). + Experience in business consulting, customer experience or health plan operations . + Ability to synthesize information ... At CVS Health , we're building a world of health...synthesis of customer feedback across multiple sources, such as plan sponsors, members, sales and service teams, brokers and… more
- Highmark Health (Pittsburgh, PA)
- … Network and other affiliated Health Systems, Product & Healthcare Services, Health Plan Operations , Actuarial Services, and Government and Commercial ... educate and engage broker community; support continued development and refinement of health plan 's distribution strategy, utilizing an internal matrixed network… more
- UCLA Health (Los Angeles, CA)
- …degree, preferred + Eight or more years in managed care, Medicare Advantage, or health plan operations , including vendor and supplemental benefit management ... the vendor lifecycle + Partner cross-functionally with internal teams (eg, Operations , Compliance, Finance, Product, and Clinical) to ensure accurate benefit… more
- Health Care Service Corporation (Richardson, TX)
- …and ensure ROI. **PREFERRED JOB REQUIREMENTS** **:** + Knowledge of Medicaid and/or Medicare health plan and PBM operations . + Additional degrees or ... This position is responsible for directing the Medicaid pharmacy operations team and responsible for analyzing and optimizing the...employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan ,… more