• Senior Director, Finance - Emory Health

    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
    Emory Healthcare/Emory University (07/15/25)
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  • Underwriting Manager | Avera Health

    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
    Avera (06/15/25)
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  • Director, Protection Services Operations

    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
    Molina Healthcare (06/29/25)
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  • Director, Health Plan Analytics…

    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
    Two95 International Inc. (06/09/25)
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  • Manager, Clinical Pharmacy Services, Health

    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
    Sanford Health (07/16/25)
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  • Administrative Fellowship, Value Based Care

    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
    Intermountain Health (06/03/25)
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  • VP, Network Mgmt & Ops (Ohio Health

    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
    Molina Healthcare (07/23/25)
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  • Director, Risk Adjustment Prospective…

    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
    Corewell Health (07/21/25)
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  • Billing Operations Representative III…

    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
    Fallon Health (07/25/25)
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  • Senior Counsel, Assistant Vice President of Legal…

    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
    RWJBarnabas Health (07/04/25)
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