- Evolent (Cheyenne, WY)
- …into actionable strategies. + **Industry Knowledge:** Deep understanding of value-based care, health plan operations , and provider partnerships. + ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health … 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
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …the department, complex care management teams, and the enterprise * Knowledgeable of health plan operations (eg networks, eligibility, benefits) * Promotes ... health care team; eg member, family, designated representative, health care provider on a plan of care that produces positive clinical results and promotes… more
- 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
Recent Jobs
-
Network Engineer I
- JB Hunt Transport (Lowell, AR)
-
Senior Staff Salesforce CRM Functional Architect
- Twist BioScience (South San Francisco, CA)
-
Manufacturing Maintenance Manager
- Advanced Technology Services (Bellwood, IL)
-
Data Engineer- Data Science Intern, Master's - Summer 2026 (Mountain View, CA)
- LinkedIn (Mountain View, CA)