- Humana (Tallahassee, FL)
- **Become a part of our caring community and help us put health first** The Director , Network Adequacy tests the overall network in each county of ... ensure the network is strong enough to support serving customers. The Director , Network Adequacy requires an in-depth understanding of how organization… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** Humana is seeking an Associate Director , Network Operations to support the Wisconsin Medicaid market. ... The Associate Director , Network Operations maintains...business including but not limited to demographics, rates, credentialing, network adequacy analysis and reporting, and contract… more
- Pfizer (Collegeville, PA)
- …country feasibility. **Support study team** + With supervision of medical monitor ( director /Sr director ) provides clinical input to protocol/study team for ... study team to ensure high quality of data eg appropriate patient population, adequacy of clinical assessments as study is ongoing. + Contributes to medical review… more
- UPMC (Moosic, PA)
- …significant responsibility for quality management and utilization management and for assuring the adequacy of the provider network for the clinical needs of ... have an exciting opportunity for a full-time Senior Medical Director to join our leadership team with UPMC Community...relationship between Community Care and the providers in its network . + Reviews proposed service denials and supervises care… more
- Pfizer (Pearl River, NY)
- …with study team to ensure high quality of data eg appropriate patient population, adequacy of clinical assessments as study is ongoing. + Conducts medical review and ... Provides protocol specific training to study team, investigators, clinical research associate , and others. + Interacts with healthcare professionals at sites… more
- Pfizer (Pearl River, NY)
- …with study team to ensure high quality of data eg, appropriate patient population, adequacy of clinical assessments as study is ongoing. + Ensures the medical review ... Provides protocol specific training to study team, investigators, clinical research associate , and others. + Interacts with healthcare professionals at sites… more
- CareFirst (Baltimore, MD)
- …use. Responsive to ad hoc large and national account requests pertaining to network and medical management issues. Monitors adequacy and utilization of ... **Resp & Qualifications** **PURPOSE:** The purpose of the Sales Enablement Manager and Network Data Analytics is to execute on business objectives with data and to… more
- CVS Health (Princeton, NJ)
- …management, and provider complaint resolution . Implementation of quality measures of network adequacy . Implementation of processes designed to improve access ... Director , Behavioral Health Administrator, CMO, Behavioral Health Director of Network Relations and all matrixed...High School Equivalent and 4 years of experience or Associate degree and 2 years of experience in health… more
- Lilly (Lebanon, IN)
- …to achieve HSE compliance and a positive site culture. + Collaborate with the Associate Director HSE to identify and define the necessary capabilities, capacity, ... reviews and ensure compliance with program elements and documentation for adequacy and completeness. **Additional Responsibility:** + Other areas of focus include… more
- Lilly (Lebanon, IN)
- …Industrial Hygiene compliance and a positive site culture. + Collaborate with the Associate Director HSE to identify and define the necessary capabilities, ... reviews and ensure compliance with program elements and documentation for adequacy and completeness. **Additional Responsibility:** + Other areas of focus include… more
- Humana (Jacksonville, NC)
- … network operations to include customer support and outreach activities, network adequacy , access to care standards, provider relationships, provider ... military health system operations and optimization including contractual performance and provider network management in order to provide the best experience for our… more
- City and County of San Francisco (San Francisco, CA)
- …its mission through the work of two main Divisions - the San Francisco Health Network and Population Health. The San Francisco Health Network is the City's only ... tissue types; + Checks morgue and other work spaces for cleanliness and adequacy of service supplies; + Checks for appropriate decedent storage temperatures and… more
- City of Toledo (Toledo, OH)
- …administration of the projects and programs is crucial. + In consultation with the Director of the Department and the Commissioner of the Division, the ability to ... the unit's internal controls, processes, policies and mechanisms to ensure adequacy , effectiveness, and compliance with the strategic priorities of the… more
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