- Centene Corporation (Jefferson City, MO)
- …engaging with executive leaders + 3 years of experience with government sponsored health plan operations and associated regulatory and contractual ... across multiple services, such as Legal, Compliance, InfoSec, Technology, and Health Plan operations ; experience speaking with regulators & auditors Pay… more
- Commonwealth Care Alliance (Boston, MA)
- … operations and satisfaction. * Strong understanding of Medicare and Medicaid health plan operations , including regulatory and compliance requirements. * ... or healthcare operations within a managed care organization, health plan , or integrated delivery system. * Demonstrated success building and managing… more
- Johns Hopkins University (Baltimore, MD)
- …changes. + Representation of Internal Audit on committees or workgroups related to health plan operations and governance. + Collaboration with Internal ... ten or more years in audit/accounting roles supporting managed care products or health plan operations . **Minimum Qualifications** + Bachelor's degree in… more
- Fallon Health (Worcester, MA)
- …on best practices in the interest of the members and the health plan . The Eligibility and Revenue Operations Representative will assist the Management team ... of purpose:** Under the direction of the Manager's, the Eligibility and Revenue Operations Representative supports Fallon Health 's mission, vision and values by… more
- Excellus BlueCross BlueShield (Rochester, NY)
- Job Description: Summary: The Actuarial Analyst performs actuarial services in support of Health Plan operations and monitors and maintains financial ... Population Health Engagement, Marketing & Sales, etc., and how they impact Health Plan operations and financials. Level III (in addition to Level II… more
- Sharp HealthCare (San Diego, CA)
- …acknowledgements. **Knowledge, Skills, and Abilities** + Demonstration of professional level of knowledge of health plan operations , health plan ... standards and system configuration. + Working knowledge of hospital, physician and health plan operations . + Strong analytical and problem solving skills;… more
- Evolent (Augusta, ME)
- …space with participation in national forums related to oncology care + Experience in health plan operations highly desirable. + Proficiency creating and ... experience + 5+ years of senior level experience leading clinical operations in a health plan environment + Skilled communicator with executive presence… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …+ Deep and broad understanding of health care delivery system and health plan operations , including knowledge of Medical Economics, Trend Management, ... , Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader… more
- Humana (Oklahoma City, OK)
- …in Oklahoma. The role will require critical thinking/problem solving skills, understanding of health plan operations , and strong interpersonal skills. Key ... financial and quality performance within the contracted working relationship with the health plan . The Provider Engagement Professional work assignments are… more
- Commonwealth Care Alliance (Boston, MA)
- …multiple projects. * Strong understanding of Medicare, Medicaid, duals program, and health plan operations , including regulatory and compliance requirements. ... multiple organizational areas and involves close collaboration with program leadership, operations teams, and external provider partners. The ideal candidate will… more