- Sanford Health (Sioux Falls, SD)
- …Full time **Weekly Hours:** 40.00 **Job Summary** The Chief Transformation Officer, Health Plan will drive the overall transformation strategy for the ... health plan , ensuring the organization remains at the forefront of healthcare innovation, digital advancement, and operational efficiency. The Chief… more
- St. Luke's Health System (Boise, ID)
- **Overview** **Data and Analytics Lead - St Luke's Health Plan ** Join Idaho's only fully integrated health system and lead data-driven innovation that ... directly improves community health outcomes. St. Luke's Health Plan is a regional health plan working to make insurance more accessible and to bring… more
- Sanford Health (Dickinson, ND)
- …will lead the ongoing analysis, planning, and management of their respective product line or Health Plan or Sanford Health System service and will identify ... market requirements and translate those requirements into business opportunities for the Health Plan . Leads the end-to-end product lifecycle, from concept and… more
- McLaren Health Care (Flint, MI)
- McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking ... and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP… more
- Sutter Health (Sacramento, CA)
- …activities and new methods of delivering health benefits that enable patients and our health plan members to access care when, where, and how they want it. ... care utilization codes). + Advanced knowledge of key operational functions of a health plan , including expert knowledge of key dimensions of health plan … more
- Banner Health (AZ)
- …of - apply today! In this role you will provide training and education on health plan benefits, coverage, costs, and eligibility. You will ensure timely and ... SUMMARY This position is responsible for the training needs of Health Plan staff and contracted providers, including development of training materials,… more
- AnMed Health (Anderson, SC)
- …reports, tracking grids and related processes. Responsibilities -Research Issues using EPIC, Health Plan Policies, guidelines & Tools, discussing with subject ... matter experts to develop appeal -Prepare escalation grids for health plan and joint committees in a timely/accurate fashion -Stay appraised on changes to … more
- Northwell Health (New York, NY)
- **Req Number** 173504 Job Description The AVP for Health Plan Performance will be responsible for driving the performance of our network solution across ... coordination and administration of policies, services and programs that optimize health plan performance for Northwell Direct. Collaborates with leadership… more
- University of Utah Health (Murray, UT)
- …1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is ... to review and approve policies. + Monitor legislative and regulatory changes impacting health plan policies. + Support governance committees for policy review… more
- LA Care Health Plan (Los Angeles, CA)
- …Range: $46,800.00 (Min.) - $52,597.00 (Mid.) - $62,270.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... low-income Los Angeles County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members, we make sure our members… more
- BayCare Health System (Clearwater, FL)
- …+ Requires deep understanding of gap closure specifications. + Knowledge of health plan operations, benefit coverage, and claims processing. + Familiarity ... in office required Equal Opportunity Employer Veterans/Disabled **Position** Grievance Specialist- Health Plan **Location** Clearwater:Park Place | Business and… more
- LA Care Health Plan (Los Angeles, CA)
- …Range: $55,245.00 (Min.) - $69,045.00 (Mid.) - $82,867.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... low-income Los Angeles County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members, we make sure our members… more
- LA Care Health Plan (Los Angeles, CA)
- …Range: $55,245.00 (Min.) - $69,045.00 (Mid.) - $82,867.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency created by the state of ... low-income Los Angeles County residents. We are the nation's largest publicly operated health plan . Serving more than 2 million members, we make sure our members… more
- BayCare Health System (Clearwater, FL)
- …Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Clinical Appeals Nurse - Health Plan **Location** Clearwater:Park Place | Business and ... consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of… more
- Trinity Health (Fresno, CA)
- …governing hospital and home care, as well as understanding of the financial structure of health plan and delivery system is preferred. Pay Range $50.84 - $73.72 ... local law. Our Commitment to Diversity and Inclusion Trinity Health is a family of 115,000 colleagues and nearly...recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and… more
- St. Luke's Health System (Boise, ID)
- …medications, the applicable pharmaceutical regulations, and requirements to align member and Health Plan cost containment strategies. + Navigate federal laws ... insurance topics to patients and providers. + Apply working knowledge of insurance plan design and terminology (deductible, max out of pocket, co-insurance, etc.) +… more
- Henry Ford Health System (Traverse City, MI)
- …of three (3) years of leadership and/or management experience. + Familiarity with health plan operations and federal and state regulations. + Familiarity with ... a broad range of health plan options (HMO, PPO, CDHP). CERTIFICATIONS/LICENSURES REQUIRED: + Must possess a valid Driver's license and maintain an acceptable… more
- Henry Ford Health System (Troy, MI)
- …emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans ... investigation of medical and pharmacy member appeals and grievances for Health Alliance Plan 's (HAP's): Commercial, Medicare Advantage, Medicare-Medicaid Program… more
- Henry Ford Health System (Troy, MI)
- …emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans ... incidents, special events, or emergencies. Additional Information + Organization: HAP ( Health Alliance Plan ) + Department: SECURITY + Shift: Day Job + Union… more
- Henry Ford Health System (Troy, MI)
- …emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans ... Health Alliance Plan (HAP) is seeking motivated and talented individuals to join our Information Technology (IT) team as interns for the Summer 2026 Intern… more