- Elevance Health (Columbus, OH)
- …strategic planning. + Experience as a management consultant. + Domain expertise with health plan operations and back office, Medicare, Medicaid, Grievances ... Wellpoint, formerly Amerigroup, is a proud member of Elevance Health 's family of brands, offering Medicaid and Medicare plans in several states. We also provide… more
- Molina Healthcare (Richmond, VA)
- **JOB DESCRIPTION** **Job Summary** Molina Health Plan Operations jobs are responsible for the development and administration of State Health Plan 's ... Under the leadership of the Plan President, this role directs and coordinates Health Plan Operations . + Accountable for ensuring Health Plan … more
- Molina Healthcare (Phoenix, AZ)
- **Job Description** **Job Summary** Molina Health Plan Operations jobs are responsible for the development and administration of State Health Plan 's ... Under the leadership of the Plan President, this role directs and coordinates Health Plan Operations . * Accountable for ensuring Health Plan … more
- Prime Healthcare (Ontario, CA)
- …actively seeking new members to join our corporate team! Responsibilities TheVice President of Health Plan Operations and Claims is responsible for the ... across all aspects of the Employee Health Plans. The VP of Health Plan Operations and Claims will provide strategic leadership and development of the… more
- Highmark Health (Pittsburgh, PA)
- …Inc. **Job Description :** This graduate level internship will support the Health Plan Financial Planning & Analysis Operations team. Day to day duties will ... include managing the reporting of health plan operating results, budget and forecasting. Will partner with other departments including Actuarial Sciences,… more
- CareFirst (Baltimore, MD)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are… more
- Cambridge Health Alliance (Cambridge, MA)
- …and in-home support services. **Job Summary:** This position supports a variety of PACE health plan operations , including working with a PACE health ... PACE Health Plan Analyst Apply Refer a...PACE Health Plan Analyst Apply Refer a Friend Back **Date...+ Coordinate vendor single case agreements with PACE clinical operations staff, vendor, TPA, etc. + Research and resolve… more
- Sutter Health (Sacramento, CA)
- …Must have advanced knowledge and understanding of California regulations that govern commercial health plan operations , including the Knox-Keene Act and ... and understanding of current regulations that govern healthcare and commercial health plan operations , including the CA Knox-Keene Act, California Insurance… more
- Martin's Point Health Care (Portland, ME)
- …as a "Great Place to Work" since 2015. Position Summary **NEW REMOTE POSITION** ** Health Plan Operations ** **APPLY TODAY!** The Senior Risk Adjustment ... Join Martin's Point Health Care - an innovative, not-for-profit health...complex conceptual analyses for all departments within Risk Adjustment Operations + Develops systematic reporting processes and procedures to… more
- Apex Health Solutions (Houston, TX)
- …Experience: Two (2) years' experience in healthcare planning/ operations or business operations focused on health plan eligibility, enrollment record ... all relevant laws, rules, regulations and accreditation standards and requirements regarding health plan enrollment operations (ERISA, Department of Labor,… more
- CareFirst (Baltimore, MD)
- …education with additional business and/or operational training. **Experience:** 10 years of health plan operations experience and 5 years administrative ... for all lines of business. The Vice President of Clinical Operations is accountable for both behavioral health and medical care management at all stages of the … more
- LA Care Health Plan (Los Angeles, CA)
- …of SQL coding. Knowledge of managed care concepts and principles and basic health plan operations . Excellent analytical, problem solving and decision-making ... (Mid.) - $188,015.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency...ratings improvement for CAHPS, HOS, HEDIS, Medication Adherence and Plan Operations Manage staff, including, but not… more
- Molina Healthcare (AZ)
- …outcomes that achieve enterprise wide growth and drive gains in efficiency and efficacy in health plan operations , health plan services, and ... governance, and execution. + Provider enterprise-wide execution leadership by partnering with health plan , corporate operations and technology leaders to… more
- Two95 International Inc. (Atlanta, GA)
- … Care Management, Computer Science, or related field * 10+ years of experience in health plan operations including but not limited to enrollment, finance, ... Job Title: Director, Health Plan Analytics Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Position Summary: As… more
- Sanford Health (Sioux Falls, SD)
- …**Weekly Hours:** 20.00 **Job Summary** Manage and apply resources to general Sanford Health Plan medical services operations , guided by experience, ... for the management of cyclical projects. Oversee processes of medical services for the health plan . Work on complex health plan medical services matters… more
- Highmark Health (Pittsburgh, PA)
- …to join our team, supporting the Customer Navigation, Service & Financial product portfolio and Health Plan Operations . This role plays a critical part in ... a focus on operational efficiency, financial impact, and customer experience. **Focus:** Health Plan Operations ; Customer Navigation, Service & Financial… more
- Walmart (Bentonville, AR)
- …accounting or auditing, with experience in benefits-related roles a plus. + Experience with health and welfare plan operations . + Certified Public Accountant ... the accounting, audit and finance related processes for our health and welfare plan as part of...compliance and related processes. + You bring knowledge of plan operations . **Education, Experience and Certifications:** +… more
- Molina Healthcare (Mid Florida, FL)
- …strategic and operating plan ; providing day-to-day leadership and management of the health plan market or product operations that mirrors the company's ... **JOB DESCRIPTION** **Job Summary** Molina Health Plan Operational Leadership roles provide...operations of the market or product of the health plan . **WORK LOCATION - Florida** **KNOWLEDGE/SKILLS/ABILITIES**… more
- Molina Healthcare (Queens, NY)
- …business plans and create SWOT analysis of individual markets + Stay informed on health plan operations , provider network, premiums, member services, claims, ... strategy in key areas in New York. The Advisor will present health plan information to providers, business advocacies, and potentially eligible members and will… more
- Highmark Health (Columbus, OH)
- …**Required** + 10 years of experience in Health Insurance Sales Management, Health Plan Operations , Provider Contracting or TPA Services. + 7 ... to the successful creation and execution of the Strategic Plan . This accountability related to the Strategic Plan...ensure the business' ongoing success. + Ensure all TPA operations are in compliance with BCBS Association requirements and… more