- Molina Healthcare (Roswell, NM)
- …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve. ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
- Molina Healthcare (Caldwell, ID)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (Vancouver, WA)
- …**Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function ... as Medicare subject matter expert and point of contact for...drive compliance and performance objectives as well as provide oversight , including service level agreements. + Works with staff… more
- CVS Health (Nashville, TN)
- …heart, each and every day. **Position Summary** Drive growth for Medicare Advantage External Distribution Partnerships by setting strategic sales goals, crafting ... achieve measurable results. Act as Chief of Staff to the Executive Director of National External Distribution, ensuring alignment and execution of strategic… more
- Molina Healthcare (Madison, WI)
- …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
- Houston Methodist (Katy, TX)
- … operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash collections ... excellence and efficiency while assisting management in accomplishing strategic and operational objectives. In addition, this position provides guidance to staff and… more
- Corewell Health (Grand Rapids, MI)
- …Supports (LTSS) is a senior leadership role responsible for the strategic and operational oversight of long-term services and supports across the organization. ... Job Summary The Director , Highly Integrated Dual Eligible Special Needs (HIDE-SNP)...of Utilization Management. Essential Functions Strategic Leadership & Program Oversight : + Develop and implement operational plans… more
- Peak Vista (Colorado Springs, CO)
- …and sustain projects that improve patient safety, clinical outcomes, patient experience, and operational efficiency. The Quality Oversight RN plays a key role in ... Quality Oversight RN Summary Title:Quality Oversight RN...outcomes. + Provide timely updates and reports to the Director of Population Health, QI Committee, Executive Team, and… more
- Humana (Albany, NY)
- …part of our caring community and help us put health first** The Director , Provider Education develops and leads initiatives, strategies, and processes focused on ... enhancing provider knowledge of Medicare and Medicaid quality and risk-adjustment programs. They help...working in close collaboration with regional market teams. The Director , Provider Education is a key leader on the… more
- CenterWell (Honolulu, HI)
- …improvement. + Work collaboratively with the Strategy Advancement and Operations Director to align clinical and operational priorities. **Quality Improvement ... and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical...skills; ability to collaborate effectively with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare … more