- Cedars-Sinai (Los Angeles, CA)
- …people throughout Los Angeles and beyond. **Req ID** : 10223 **Working Title** : Program Manager - Managed Care ( Hybrid ) **Department** : MNS Managed ... **Job Description** The Program Manager is responsible for supporting...Familiarity with regulatory standards including but not limited to: NCQA , ICE, DMHC, DHCS, CMS and contracted health plans.… more
- Henry Ford Health System (Troy, MI)
- …Department Responsibilities: + Project management and financial management analysis. + NCQA accreditation program management. + Vendor management of clinical ... projects through entire life cycle including large dept. projects; works with manager /leaders to manages customer expectations and socializes ideas to gain buy-in… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …transform healthcare? Bring your true colors to blue. The Role:The Medical Clinical Program Manager will focus on utilization management compliance and audit ... Team: As an integral part of HMM Quality and Compliance team, the Clinical Program Manager works through the influence as an individual contributor while… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …us transform healthcare? Bring your true colors to blue. The RoleThe Sr. Program Manager , Clinical Quality is responsible for developing, managing, coordinating, ... may also coordinate accreditation activities on behalf of the organization. The Sr. Program Manager , Clinical Quality works closely and collaboratively with all… more
- Highmark Health (Harrisburg, PA)
- **Company :** Allegheny Health Network **Job Description :** ** Hybrid Position:** Provide support to several practice locations, 3 days in office and 2 days work ... from home. Location and schedule discussed with hiring manager . **GENERAL OVERVIEW:** Responsible for working collaboratively with primary care providers and care… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …healthcare? Bring your true colors to blue. The Pharmacy Operations Clinical Pharmacist Manager manages and directs clinical staff in the day to day clinical ... in accordance with UM guidelines and are compliant with NCQA and CMS guidelines. In this role, you will...of Commercial and Medicare Part D formulary and clinical program offerings. + Contribute to a culture of service… more
- Humana (Madison, WI)
- …and help us put health first** Humana is seeking a Provider Contracting Manager to join the Wisconsin Medicaid Market (iCare) team. The Provider Contracting ... Manager will oversee a talented group of Provider Contracting...the iCare Provider Network to meet CMS, DHS, and NCQA standards. + Traveling throughout Wisconsin for provider meetings… more
- Humana (Kissimmee, FL)
- …of our caring community and help us put health first** The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or ... the care and wellbeing of members. The Field Care Manager Nurse 2 work assignments are varied and frequently...**Preferred Qualifications** + A good understanding of AHCA regulations, NCQA and Medicaid guidelines + Managed care experience +… more
- AmeriHealth Caritas (Newark, DE)
- …point of contact and be an advocate for members in the care coordination program . In addition the Care Manager /Coordinator will oversee these same care ... generation of healthcare leaders. AmeriHealth Caritas Delaware is seeking a Pediatric Case Manager to support Kent County. ;The Care Manager will be responsible… more
- UPMC (Erie, PA)
- UPMC Community Care Behavioral Health is hiring a Clinical Manager for the Care Management team in Erie, PA! This position will work standard business hours Monday - ... Friday and will work in a hybrid structure with time spent working in the office,...travelling in the community and working remotely. The Clinical Manager is responsible for supervising the day-to-day operations of… more