- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …a bachelor's degree level RN/clinician with five or more years of clinical and managed care experience with two to three years of supervisory experience and ... establishing and maintaining a system that evaluates the quality of member care . These projects include supporting Case Management program design and quality… more
- Evolent (Jackson, MS)
- …discussions . Experience building and developing team members . Knowledge of the managed care and oncology market trends (both payers and risk-bearing ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...& Enablement to join the growth team as a leader . Role Overview: The VP, Product Marketing & Enablement… more
- Trinity Health (Latham, NY)
- …communication skills are required. + Knowledge of working with community agencies and managed care representatives is desired. + Experience working with a ... Latham, an affiliate of St. Peter's Health Partners, we care for more people in more places. **Position Highlights:**...more people in more places. **Position Highlights:** + **Recognized leader :** Magnet Hospital in the Capital Region + **Quality… more
- Prime Therapeutics (Pierre, SD)
- …12 years of work experience in medical and pharmacy drug management within a PBM or managed care organization + Must be eligible to work in the United States ... business initiatives and the delivery of innovative solutions. **Responsibilities** + Lead the development and assessment of innovative clinical solutions and the… more
- Molina Healthcare (GA)
- …**Required Experience** + 7+ years of business analysis experience, + 6+ years managed care experience. + Demonstrates expertise in a variety of concepts, ... practices, and procedures applicable to job-related subject areas. **Preferred Education** Graduate Degree or equivalent combination of education and experience **Preferred Experience** + 7-9 years project manager experience + Provider claims data experience +… more
- Peoples Health Centers Family of Companies (St. Louis, MO)
- …by changes in provider schedules as necessary according to protocol. Works with Managed Care and Training and Development Coordinators to build proper curriculum ... for registration staff. Other duties as assigned. Supervisory Responsibilities: Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include training employees; planning, addressing… more
- Help at Home (Brooklyn, NY)
- …ensures compliance with New York State Department of Health (DOH) regulations, Managed Long-Term Care (MLTC) program requirements, and Federal guidelines. The ... Home is the leading national provider of in-home personal care services, where our mission is to enable individuals...good fit for you. **_Job Summary:_** The Clinical Operations Leader is responsible for the strategic oversight and clinical… more
- Guthrie (Sayre, PA)
- …workflows/processes that impact the Revenue Integrity functions: chargemaster, Federal, State & managed care contract rule development and charge capture and ... support leadership. This role serves as the Revenue Cycle Revenue Integrity leader for The Guthrie Clinic to internal and external organizations, including… more
- Ascension Health (Jacksonville, FL)
- …Review and Credentialing + Growth and Strategic Planning + Population Health + Managed Care + Oversees the development and continuous improvement of services, ... + Responsible for monitoring, measurement and quality improvement of clinical care utilizing evidence-based best practices to support, promote and oversee patient… more
- WelbeHealth (CA)
- …management, preferably within a complex healthcare system (eg PACE, Health System, Managed Care , Health Plan) + Exceptional relationship-building skills, with ... and Key Performance Indicators (KPIs) to ensure seamless, timely, and high-quality care . **Essential Job Duties:** + **Performance Leadership:** Lead joint… more