• Manager Payment Integrity - Remote

    Martin's Point Health Care (Portland, ME)
    Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a ... people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an… more
    Martin's Point Health Care (11/26/25)
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  • Behavioral Health Nurse - Managed Care

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …providers, and interdisciplinary teams to assess behavioral health needs, develop individualized care plans, and ensure cost -effective, quality care in ... are cost -effective and meet quality standards, consistent with managed care requirements and clinical best practices. + Maintain accurate and timely… more
    DOCTORS HEALTHCARE PLANS, INC. (01/01/26)
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  • Pharmacy Director, Long Term Care

    Trinity Health (Livonia, MI)
    …decisions, and outcomes. Directs alignment and standardization for Pharmacy Long Term Care Operations to provide high-quality, cost -effective patient ... 25% to 45% travel.** **POSITION PURPOSE** The Pharmacy Director Long Term Care Operations is a licensed registered pharmacist accountable for leading, managing and… more
    Trinity Health (12/08/25)
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  • Category Manager - Truck Care

    Love's Travel Stops & Country Stores (Oklahoma City, OK)
    …and develop and execute category sourcing strategies focused on minimizing total cost of ownership and maximizing service quality. **Job Functions** : + **Enables ... Agreements + Leads and conducts the RFP process, bid analysis and review, contract negotiations, and blanket purchase agreement creation + **Identify and realize … more
    Love's Travel Stops & Country Stores (12/19/25)
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  • Principal Engineer, Standards and Design

    MetroLink (Los Angeles, CA)
    …safely with no or minimal impacts to railroad operations. + Manage consultant contracts, contract task orders, schedule, cost , and scope. + Coordinate the work ... an exhaustive list of responsibilities. + Manage Consultant Design Support Services Contract . + Review and assure compliance with Railroad design requirements for… more
    MetroLink (10/16/25)
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  • AVP, Medicare Medical Services

    UPMC (Pittsburgh, PA)
    …retrospective reviews, member grievances, provider appeals, and potential quality of care concerns. + Provide expedited review and determination of medically ... and execute on our population health strategy, clinical and provider operations, and State contract and CMS...implementation of medical management initiatives to improve quality and cost effectiveness of care delivered. + Key… more
    UPMC (12/09/25)
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  • Regional VP, Health Services

    Humana (Tallahassee, FL)
    … efficiency, and population health outcomes through strategic provider partnerships, data-informed decision-making, and cross-functional collaboration. The RVP ... and maintain trusted relationships with CMOs and senior executive/clinical leaders at provider and care delivery partner organizations. First and foremost, this… more
    Humana (12/31/25)
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  • Physician (Primary Care )

    Veterans Affairs, Veterans Health Administration (Georgetown, DE)
    …of the Veteran. The incumbent references quality improvement information and organizes patient care needs to assure safe, efficient, and cost -effective care ... The incumbent works as a member of a primary care team consisting of clerical staff, nurses, physicians, social...well as occasional travel to other VA clinics to provide clinical coverage. The candidate must be willing to:… more
    Veterans Affairs, Veterans Health Administration (12/13/25)
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  • Ambulatory Social Work Care Manager I

    Rush University Medical Center (Chicago, IL)
    …and anticipated) with available resources and proactively resolve barriers. Promotes cost -effective quality care services. * Participates in development, ... which is specific to the patient/family learning abilities and language preference. * Identifies care management contract outcomes by using care management … more
    Rush University Medical Center (11/25/25)
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  • Managed Care Coordinator

    Elevance Health (Halifax, VA)
    …cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. + The process does not involve clinical ... **Managed Care Coordinator** **Sign On Bonus-$1000** **Location:** The locations... Program, as required by applicable state law and contract . **How you will make an impact:** + Responsible… more
    Elevance Health (12/06/25)
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