- Emory Healthcare/Emory University (Atlanta, GA)
- …academic institutions or integrated health systems. + Deep knowledge of health plan operations , claims analysis, actuarial principles and healthcare ... will serve as the financial leader of the Emory Health Plan , a self-funded health ...networks and care management programs. + Collaborates with Population Health and Clinical Operations to quantify ROI… more
- Avera (Denver, CO)
- … insurance underwriting, with a focus on risk assessment. + Comprehensive knowledge of health plan operations , products, and regulations. + Strong analytical ... authority limits. + Conduct risk assessments for group and Medicare Supplement health plan accounts. + Provide insights on risk profiles and recommend strategies… more
- Molina Healthcare (KY)
- …(HR), Information Technology (IT), Legal, Compliance, Travel, Government Affairs, Communications and Health Plan Operations . + Designs, implements, and ... organizations, technical staff, and business units in the Protection Services Operations Center (PSOC) Team. Responsible for the monitoring and intelligence,… 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
- Sanford Health (Sioux Falls, SD)
- …providers to optimize member services. This position supervises the clinical aspects of Health Plan Pharmacy department operations to include integration ... time **Weekly Hours:** 40.00 **Job Summary** The Manager works closely with Health Plan providers and staff to coordinate Pharmacy Benefit services and promote… more
- Intermountain Health (Las Vegas, NV)
- …medical group, and rural facilities (home base: Salt Lake City, UT) + ** Health Plan Operations / Select Health ... Health - Plan - Operations 2026-2027\_R141550)** - Focus on health plan operations , value-based care, and collaboration with the healthcare… more
- Molina Healthcare (Dayton, OH)
- …strategic and operating plan ; providing day-to-day leadership and management of the health plan market or product operations that mirrors the company's ... **JOB DESCRIPTION** **Job Summary** Molina Health Plan Operational Leadership roles provide...operations of the market or product of the health plan . **KNOWLEDGE/SKILLS/ABILITIES** Plans, organizes, staffs, and… more
- Corewell Health (Grand Rapids, MI)
- …of accountability and efficiency.This leader will be responsible for building out core health plan -based risk adjustment operations , as well as developing ... Guidelines. + Serve as point person for relationships with health plan partners, including contracting and revenue...experience in Risk Adjustment in a health plan or medical group setting managing operations /processes… more
- Fallon Health (Worcester, MA)
- …on best practices in the interest of the members and the health plan . The Enrollment & Billing Operations Representative III is considered the main resource ... Under the direction of the Supervisor or Manager, the Enrollment & Billing Operations Representative III supports Fallon Health 's mission, vision and values by… more
- RWJBarnabas Health (West Orange, NJ)
- … and welfare benefit plan experience + Deep expertise in benefits contracting, health plan operations , and regulatory frameworks governing plan ... + Provide legal counsel on all aspects of employee benefits, including plan design, implementation, administration, and compliance for health , welfare,… more
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