• Director , Operational…

    Molina Healthcare (Provo, UT)
    **Job Description: Director , Operational Oversight ( Medicare )** **Job Summary** Responsible for planning, developing and directing the implementation of ... operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve.… more
    Molina Healthcare (09/28/25)
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  • Senior Analyst, Operational Regulatory…

    Molina Healthcare (Orem, UT)
    …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 (08/22/25)
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  • Director , Medicare Segment…

    Molina Healthcare (Salt Lake City, UT)
    …**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
    Molina Healthcare (09/07/25)
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  • Director , Provider Network Management…

    Molina Healthcare (Orem, UT)
    …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
    Molina Healthcare (08/20/25)
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  • National Medical Director , Home-Based Care…

    CenterWell (Salt Lake City, UT)
    …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
    CenterWell (10/02/25)
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  • Clinical Account Director - Remote

    Prime Therapeutics (Salt Lake City, UT)
    …passion and drives every decision we make. **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account Director is ... As the primary point of contact for their designated BCBS clients, the director promotes and recommends Prime standard offerings to meet client requirements and… more
    Prime Therapeutics (10/01/25)
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  • Director , Appeals & Grievances (Remote)

    Molina Healthcare (Layton, UT)
    …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
    Molina Healthcare (09/26/25)
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  • Director , Internal Audit

    Waystar (Lehi, UT)
    **ABOUT THIS POSITION** The Internal Audit Director is a critical leadership role responsible for developing, implementing, and overseeing the internal audit ... across the organization. The position will be focused on oversight of the entire SOX compliance program (including both...and ITGCs) and may expand to cover risk based operational audits in the future. The ideal candidate should… more
    Waystar (09/19/25)
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  • Director , Denial Resource Center

    Baylor Scott & White Health (Salt Lake City, UT)
    …, Denial Resource Center is responsible for the strategic planning, evaluation, and operational oversight of the clinical denial management function for Baylor ... Scott and White Health (BSWH). The Director , Denial Resource Center will lead a highly skilled...function for BSWH. + Recommends and implements strategic and operational plans and priorities for clinical denial management aligned… more
    Baylor Scott & White Health (10/04/25)
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  • Director Quality Improvements

    Banner Health (UT)
    …related to opportunities in Peer Review investigations and other operational /clinical priorities to align performance improvement opportunities with system and ... of the organization to achieve objectives such as Annual Initiatives, Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (JC) standards of… more
    Banner Health (10/02/25)
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