- Sanford Health (Sioux Falls, SD)
- …resolution. Lead and manage the end-to-end appeals and grievances process for all product lines, ensuring compliance with federal and state requirements. ... grievance processes across all product lines, including ACA, Commercial, Medicare Advantage, Medicaid , DSNP, and ISNP. This role ensures adherence to all state,… more
- Cleveland Clinic (Cleveland, OH)
- …Certification Program (HACP) or Certified Joint Commission Professional (CJCP) + Process Improvement Certification preferred: Lean, Six Sigma, etc. + ... reviews, data analysis and decision-making from data. Identify and address root causes to lead to sustainable improvement . + Act as a champion for continuous … more
- Banner Health (Phoenix, AZ)
- …entity leadership to plan and coordinate local Quality Councils/QAPIs. 2. Performance and Process Improvement -Serves as a subject matter expert in performance ... teams. CORE FUNCTIONS 1. Quality Leadership and Integration - Lead the integration of quality into the fabric of...and process improvement , project management and change management… more
- State of Minnesota (St. Paul, MN)
- …position is to supervise the TRU team and their work. TRU exists to assure that Medicaid is the payor of last resort in those cases where a third-party is liable to ... in litigation. The TRU Supervisor is responsible for the process and outcomes for over 3,000 active cases per...active cases per year impacting over $3-7 million in Medicaid and subsistence funds (MFIP, GA, GRH, etc.)._ _They… more
- Cleveland Clinic (Mayfield Heights, OH)
- …Certification Program (HACP) or Certified Joint Commission Professional (CJCP) + Process Improvement Certification preferred: Lean, Six Sigma, etc. + ... reviews, data analysis and decision-making from data. Identify and address root causes to lead to sustainable improvement . + Act as a champion for continuous … more
- Elevance Health (Durham, NC)
- _We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid -enrolled infants, children, youth, young ... serving as a liaison with and overseeing the quality improvement activities/projects/programs for one or more states within a...and ensures integration of quality into the overall business process . + Works with the clinical intervention team to… more
- Humana (Trenton, NJ)
- …+ 3 or more years of experience in sales strategy, business optimization, or process improvement , ideally within an omnichannel or transformation environment + 3 ... productivity, increase conversion rates and/or elevate member satisfaction + Lead continuous improvement programs, working cross-functionally to...or more years of experience with continuous improvement , business process mgmt., process … more
- Providence (OR)
- …+ Set strategic and performance goals for the departments, monitor results, and drive process improvement . **Innovation Driver:** + Lead and participate in ... then we have the perfect opportunity for you to lead our Financial Counseling team! **The Role:** As the...efficiency and effectiveness of Financial Assistance Programs and the Medicaid submission process for 51 Providence and… more
- Alameda Health System (Oakland, CA)
- …education to enhance operational consistency and compliance. Strong project management and process improvement skills are essential in this role. Project ... Six Sigma certification (Green Belt or higher) are strongly preferred to support process improvement and operational efficiency initiatives. Pay Range: _$51.83 -… more
- Covenant Health Inc. (Knoxville, TN)
- …process . + Adheres to established policies and procedures, objectives, process improvement initiatives, safety, environmental and infection control standards. ... knowledge of State and Federal regulations, HCFA guidelines, HIPAA, Medicare/ Medicaid guidelines and other Third Party Payor requirements assuring departmental… more