- Molina Healthcare (Layton, UT)
- …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 (West Valley City, UT)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (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 (Orem, 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 (Salt Lake City, UT)
- …and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's ... for leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible...DSNP, HIDE, FIDE, EAE, AIP, etc. * Provides direct oversight , monitoring and training of provider disputes and appeals… more
- CenterWell (Salt Lake City, UT)
- …and communicate remediation plan to IPA Dyad partners. + Partners with market operational leaders to identify operational issues that impact clinician and coder ... staff workload and redistribute resources as needed to meet market operational demands. + Monitor coding processes, identify inefficiency, and develop… more
- CenterWell (Salt Lake City, UT)
- …Director , the Senior Strategy Advancement Professional will bring a combination of operational support, analyst skills, and strategy oversight to the role. ... (ACO) business. This role will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid… more
- Molina Healthcare (West Valley City, UT)
- …in collaboration with the Manager or Director . * Keeps Manager or Director apprised of operational issues, including staffing resources, program and system ... drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient… more
- Molina Healthcare (Provo, UT)
- …strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core ... contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight . Tighter knit proximity ongoing after contract. * In conjunction… more
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