- Trinity Health (Syracuse, NY)
- …Office CDM and Compliance team. Ensures CDM codes are compliant with Medicare and local payer guidelines. Works with various clinical departments and physicians ... root cause analysis on issues with pre-billing and identifies opportunities for optimization of revenue. May be responsible for local pricing decisions. Required to… more
- Humana (Albany, NY)
- …that are responsive to local competitive and provider dynamics; (2) Development of Medicare Product strategies that are aligned with the unique needs of ... corporate, functional, and business unit leaders. Select project examples include (1) Optimization of Medicare enrollment growth strategy, such as balancing… more
- CVS Health (Hartford, CT)
- …and affordable. **Position Summary** CVS Health is looking for a technical product manager to join the Multi-Carrier Solutions team, an exciting and fast-paced ... new growth area within the organization. As a technical Product Manager & Adobe Target Developer, you will lead.... Collaborating to ID the best technical approach for implementation of the activities and optimizations, based on understanding… more
- Independent Health (Buffalo, NY)
- …improvement in quality of care and health outcomes as measured by HEDIS, Medicare Star, and QARR, including parameters that reflect the organization's health equity ... accountable for compilation and submission of key quality performance requirements for Medicare Star, Medicaid QARR, and Commercial NCQA HEDIS and CAHPS reporting.… more
- Elevance Health (Columbus, OH)
- …in driving affordability across multiple lines of business (Commercial, Medicaid, Medicare , ASO clients) by partnering with internal and external stakeholders to ... drive formulary strategy and rebate optimization . This Director will collaborate with cross-functional partners to...to advance CarelonRx's unique value proposition across multiple formulary product solutions. _The position will work in a hybrid… more
- The Cigna Group (Bloomfield, CT)
- …upsell services to grow the business. Cross functional teams include Product Management, Sales Enablement, Finance, Regulated Markets, Implementation , ... Sr. Account Executive is responsible for planning, internal coordination, implementation , maintenance, and communication of client strategic and financial activities… more
- Humana (Columbus, OH)
- …fully and be their most productive. This Director, IT Vendor Management (Vended Software Optimization , IT Hardware VMO, IT Services VMO) has oversight of a team of ... function, evaluates vendor performance, needs assessment, contractual compliance, spend optimization , value creation and risk management. + Makes decisions related… more
- Convey Health Solutions (Chicago, IL)
- …and Rewards & Incentives Programs. You will collaborate closely with product managers, data scientists, analysts, and business stakeholders to provide the ... meets regulatory compliance requirements (eg, HIPAA) and aligns with Star Analytics product development. * Data Quality and Validation: * Implement and maintain… more
- HealthEdge Software Inc (Columbus, OH)
- …partners to ensure the effectiveness and relevance of our edits. **The Product :** _With Source_ , we're changing the industry narrative, providing a more ... payment integrity, and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration… more
- CVS Health (Richardson, TX)
- …business processes, challenges, and objectives, translating these into effective implementation plans. + Assess issue risks and develop mitigation strategies ... for enterprise applications, focusing on growth, performance tuning, and optimization . + Analyzed enterprise platforms to identify deficiencies and recommend… more
- Houston Methodist (The Woodlands, TX)
- …to enhance consistent clinical, service and financial outcomes through the implementation of exemplar practice. This position provides leadership and direction to ... discharge planning, progression of care, documentation of improvement, and Medicare Conditions of Participation. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Ensures a… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …providing strategic recommendations to senior leadership and overseeing strategy implementation with the Payer & Trade Accounts. **Responsibilities** Strategic ... providing insights to guide business decisions. + Lead the development and optimization of distribution strategies for both new and existing products in response… more