• Director, Care Management

    LA Care Health Plan (Los Angeles, CA)
    …assessments and interdisciplinary care plan and care team programs, population health management . The Director is also responsible for outreaching and ... delegated Participating Physician Group (PPG) functions. Duties Continued Internal Health Plan Operational Management : Proactively...to change. LA Care offers a wide range of benefits including + Paid Time Off (PTO) + Tuition… more
    LA Care Health Plan (09/12/24)
    - Save Job - Related Jobs - Block Source
  • Senior Benefits Analyst

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... and emerging developments in the employee health benefits . + Review clients ERISA medical benefit ...Project management experience required. About At Brighton Health Plan Solutions, LLC, our people are… more
    Brighton Health Plan Solutions, LLC (10/18/24)
    - Save Job - Related Jobs - Block Source
  • Director of Training, Children and Families…

    Elevance Health (Charlotte, NC)
    …with functional managers and participating in cross-functional workgroups to support corporate and health plan management . + Evaluates program operations to ... impact: + Develop and deliver customized training and engagement strategies, ensuring alignment with health plan and NCDHHS requirements. + Manage a team of 6… more
    Elevance Health (11/02/24)
    - Save Job - Related Jobs - Block Source
  • Programmer Analyst

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... About The Role Brighton Health Plan Solutions is growing. We...Programmer Analyst to join our technology team, focusing on benefits and claims process configuration and programming to support… more
    Brighton Health Plan Solutions, LLC (11/15/24)
    - Save Job - Related Jobs - Block Source
  • Customer Service Representative

    Brighton Health Plan Solutions, LLC (New York, NY)
    …cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider ... chat, and voice. + Previous multi-channel experience is a plus. About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of… more
    Brighton Health Plan Solutions, LLC (09/12/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Care Manager (RN) - Health

    UPMC (Pittsburgh, PA)
    …the Discharge Plan Managers, identifying members who might have higher needs and benefit from Health Plan resources. Additionally, they will help to ... and the plan of care. + Document all activities in the Health Plan 's care management tracking system following Health + Successfully engage… more
    UPMC (10/15/24)
    - Save Job - Related Jobs - Block Source
  • Medical Director - Health Plan

    Martin's Point Health Care (Portland, ME)
    …aspects of the health plan 's medical policy, clinical utilization management programs and clinical benefit determinations. This role works closely with ... and NCQA accreditation requirements. This includes review of the Health Plan 's Annual Quality Management .... + Provides clinical expertise to support product and benefit development efforts + Manages the clinical aspects of… more
    Martin's Point Health Care (09/19/24)
    - Save Job - Related Jobs - Block Source
  • Care Manager, Health Plan

    Magellan Health Services (San Diego, CA)
    …team approach, including all participants of the Interdisciplinary Care Plan team, Health Plan Medical Care Management where appropriate, to ensure ... implement solutions that directly influence quality of care. Understanding of plan benefit structures, psychiatric/medical terminology, call center terminology… more
    Magellan Health Services (11/19/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Manager-Selikoff Centers…

    Mount Sinai Health System (New York, NY)
    …the Nursing Department. + Performs utilization review in accordance with all regulations, using health plan management tool based on program guidelines and ... Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations within… more
    Mount Sinai Health System (10/31/24)
    - Save Job - Related Jobs - Block Source
  • Health Solutions Account Executive

    AON (Lincolnshire, IL)
    …+ Benchmarking + Plan design + Pricing strategy + Bid/selection projects + Health plan management + Wellness + Leading-edge program approaches + ... company, brokerage or in the Health and Benefits discipline. + Complex project management experience... design + Pricing strategy + Bid/selection projects + Health plan management + Wellness… more
    AON (09/12/24)
    - Save Job - Related Jobs - Block Source
  • Pharmacy Benefits Program Director; HSO…

    Mount Sinai Health System (New York, NY)
    …6 years experience in the healthcare industry, with focus on Pharmacy Health Plan or Pharmacy Benefit Management . + Proven capabilities in strategic ... Therapeutics Committee. + Ensures the clinical integrity of the Health Plan pharmacy offering. + Partners with...growth. + Participate in meetings and presentations to review benefits management performance. + Act as pharmacy… more
    Mount Sinai Health System (10/29/24)
    - Save Job - Related Jobs - Block Source
  • RN Case Manager D-SNP (Hybrid - Troy, MI)…

    Henry Ford Health System (Troy, MI)
    General Summary: Responsible for case management activities for Health Alliance Plan (HAP) dual eligible members using a multi-disciplinary, patient-centered ... case management . Additional Information + Organization: HAP ( Health Alliance Plan ) + Department: Case ...Ford academic healthcare campus. Learn more at henryford.com/careers . Benefits The health and overall well-being of… more
    Henry Ford Health System (11/13/24)
    - Save Job - Related Jobs - Block Source
  • Supervisor, Quality Configuration Assurance

    LA Care Health Plan (Los Angeles, CA)
    …experience working with a California Medi-Cal managed care plan or commercial health plan , medical group, or management services organization. Skills ... Assurance Job Category: Information Technology Department: IT Enterprise Data Management Location: Los Angeles, CA, US, 90017 Position Type:...(Mid.) - $163,492.00 (Max.) Established in 1997, LA Care Health Plan is an independent public agency… more
    LA Care Health Plan (10/30/24)
    - Save Job - Related Jobs - Block Source
  • Mgr II GBD Special Programs

    Elevance Health (Knoxville, TN)
    …an impact:** + Directs and oversees program operations in support of corporate and health plan management . + Directs and collaborates with functional ... collective bargaining agreement), medical, dental, vision, short and long term disability benefits , 401(k) +match, stock purchase plan , life insurance, wellness… more
    Elevance Health (11/07/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Director- Early Childhood Support…

    Magellan Health Services (Hodge, LA)
    …a member of health plan Quality Insurance Committee and co-chair health plan Utilization Management Committee. + Collects, analyzes and prepares ... management functions to achieve the business and clinical outcomes for the health plan , meeting contract requirements, National Committee of Quality Assurance… more
    Magellan Health Services (10/24/24)
    - Save Job - Related Jobs - Block Source
  • Dir II Medicaid State Ops

    Elevance Health (Metairie, LA)
    …and community partners successfully participate. + Leads and manages the local Health Plan performance management /operating gain improvement activities. + ... 3850 N CAUSEWAY BLVD. Responsible for fiscal and operational management of state regional Health Plans. Primary...goals and objectives of regional area within a State Health Plan . + Along with State CEO… more
    Elevance Health (11/15/24)
    - Save Job - Related Jobs - Block Source
  • Care Manager (Care Management )

    Sea Mar Community Health Centers (Vancouver, WA)
    …Individual and Family Support. Care Management team members will create a health action plan setting self- management goals with the patient and ... department in Clark County. The Care Manager supervises an interdisciplinary care management team assisting high-risk patients with behavioral health and medical… more
    Sea Mar Community Health Centers (10/18/24)
    - Save Job - Related Jobs - Block Source
  • Medical Director - Oklahoma Medicaid

    CVS Health (Oklahoma City, OK)
    …This is a regional role that primarily supports the Aetna Better Health Plan of Oklahoma. This UM (Utilization Management ) Medical Director will be a "Work ... Independent Review Organization a Plus **Preferred Qualifications:** -Preferred Oklahoma residency - Health plan /payor Utilization Management / Review… more
    CVS Health (10/03/24)
    - Save Job - Related Jobs - Block Source
  • Medical Director - Florida Medicaid

    CVS Health (Tallahassee, FL)
    …or working for an Independent Review Organization a Plus **Preferred Qualifications:** - Health plan /payor Utilization Management / Review experience. ... Medicine Specialty Preferred. - Prior UM experience working at Health Plan / Insurer or experience as...to eligible employees, and short-term and long term disability benefits . CVS Health also offers numerous well-being… more
    CVS Health (10/04/24)
    - Save Job - Related Jobs - Block Source
  • Environmental, Safety & Health Lead

    Bechtel Corporation (Salt Lake City, UT)
    …and support needs. + Prepares or participates in preparation of the project Safety and Health Management Plan , safety and health specific plans, ... Project Overview: Bechtel Renewables team is to deliver the project management , engineering, procurement, construction, startup, and testing services for a… more
    Bechtel Corporation (11/07/24)
    - Save Job - Related Jobs - Block Source