- Point32Health (Canton, MA)
- …within the health insurance or healthcare payer space. + Deep knowledge of health plan operations , member and provider journeys, and digital health ... healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Management, Product Development, Medical Management, Marketing & Sales, etc. and how they impact Health Plan operations , financials and forecasts. + In depth ... rating methods and models. + Provides guidance to the Health Plan product development process. + Oversees...operations . + Provides counsel on current and proposed health plan Underwriting guidelines for commercial and… more
- Texas Health Resources (Arlington, TX)
- …a top choice in North Texas for emergency care, cancer services, and women's health . Job Qualifications OPERATIONS : Plan , organize, and delegate activities ... for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health ...and develop solutions to barriers. QUALITY PATIENT CARE OUTCOMES: Plan , manage, patient care processes to improve performance. Facilitate… more
- Amazon (Seattle, WA)
- …understanding of ERISA compliance requirements, HIPAA, extensive experience in pharmacy benefit or health plan operations , health tech integrations, data ... pharmacy benefit program, evaluating key measures to continually optimize program operations and strategy, with an overarching commitment to member experience. This… more
- Prime Healthcare (Ontario, CA)
- …and state financial reporting regulations. + Collaborate with cross-functional teams including Health Plan Operations , Patient Access, Marketing, IT, and ... Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare...implement, and manage the Revenue Integrity & CDM Compliance Plan . + Ensure compliance with CMS Price Transparency Rule… more
- Healthfirst (NY)
- …using Agile methodologies. Exposure to Scaled Agile (SAFe) preferred. + Experience working with health plan operations and IT + Experience working as a ... by collaborating closely with peers, leaders, and staff throughout Operations to ensure the appropriate parties are contributing. +...+ Experience leading large scale change initiative in a health plan setting + Demonstrated understanding and… more
- Robert Half The Creative Group (Long Beach, CA)
- …workflows. This position is ideal for someone with a strong background in Medicare or health plan operations and a proven ability to lead structured ... and review sessions. Requirements * Extensive experience in Medicare, healthcare, or health plan workflows. * Strong proficiency in creating service blueprints… 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
- Datavant (Honolulu, HI)
- …for storage and computing + Experience with machine learning algorithms + Knowledgeable in health plan operations and reporting We are committed to building ... a data platform company and the world's leader in health data exchange. Our vision is that every healthcare...Our platform is powered by the largest, most diverse health data network in the US, enabling data to… more
- CareFirst (Baltimore, MD)
- …a health care system or payor organization, as well as health plan or health insurance operations (eg networks, eligibility, benefits). + Excellent ... Manager researches and analyzes a member's medical and behavioral health needs and healthcare cost drivers. The Care Manager...interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads… more
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