• Vice President of Health Plan

    Prime Healthcare (Ontario, CA)
    …team! Responsibilities This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for ... 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
    Prime Healthcare (12/24/25)
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  • Clinical Director, Health Plan

    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
    McLaren Health Care (12/22/25)
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  • Medicare Sales Lead Sector Consultant (Hybrid -…

    Henry Ford Health System (Traverse City, MI)
    …Minimum of three (3) years of leadership and/or management experience. + Familiarity with health plan operations and federal and state regulations. + ... to provide expertise, knowledge and recommendations for seamless daily operations . Bring concerns and pending issues to the Director...Familiarity with a broad range of health plan options (HMO, PPO, CDHP). CERTIFICATIONS/LICENSURES… more
    Henry Ford Health System (12/23/25)
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  • Senior Director of Enterprise Innovation…

    Emory Healthcare/Emory University (Atlanta, GA)
    …transformation, technology implementations, or operational redesign programs + Deep understanding of health plan operations including benefits design, claims ... our academic community. **Description** **Architect the Future of Healthcare Delivery** Emory Health Plan seeks a visionary transformation leader to orchestrate… more
    Emory Healthcare/Emory University (12/21/25)
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  • Associate Vice President, Finance - Emory…

    Emory Healthcare/Emory University (Atlanta, GA)
    …fiscal discipline + Lead annual budgeting, forecasting, and scenario planning for $1.3B health plan operations + Serve as principal financial advisor ... of our academic community. **Description** **Transform Healthcare Finance at Scale** Emory Health Plan seeks an exceptional finance leader to architect and… more
    Emory Healthcare/Emory University (11/01/25)
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  • Clinical Product Analyst, Intermediate…

    UPMC (Pittsburgh, PA)
    …of the time. + Work that matters-your contributions will directly impact patient care and health plan operations . + Opportunities to grow your technical and ... with Azure tool. + Knowledge of pharmacy and/or care management within a health plan . + Understanding of enrollment processes at a payer organization. Why You'll… more
    UPMC (01/08/26)
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  • Director, Health Plan Analytics…

    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
    Two95 International Inc. (12/08/25)
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  • AVP, Operations ( Health Plan

    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
    Northwell Health (12/20/25)
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  • Senior Analyst, Plan Sponsor

    CVS Health (Hartford, CT)
    …manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations . The PSL role has responsibility ... manage, and resolve escalated and complex global issues for Claims/Calls, PSS, and health plan back-office operations . The Plan Sponsor Liaisons serve as… more
    CVS Health (12/06/25)
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  • Health Services IT Supervisor

    TEKsystems (Martinez, CA)
    …Knowledge, Skills, and Abilities Knowledge of: Principles of healthcare administration and health plan operations Principles of leadership, management, ... and COO to assist in future planning for the Health Plan Skills Supervision, Support, Epic Top...our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions.… more
    TEKsystems (01/08/26)
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  • Senior Program Manager - DC Market…

    CareFirst (Washington, DC)
    …strategy to execution. This position will report to CareFirst BlueCross BlueShield Community Health Plan - Chief External Operations Officer. **ESSENTIAL ... market expansion + Lead day-to-day operations of the Healthy DC Plan Basic Health Plan in DC. + Develop and oversee day-to-day operations for… more
    CareFirst (12/18/25)
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  • Home Health RN Clinical Manager

    Sea Mar Community Health Centers (Seattle, WA)
    …designation of priority objectives for the Home Health Division. + Develop the Home Health plan for clinical operations and provide for efficient use of ... community. Essential Duties and Responsibilities: + Planning: + Develop the Home Health Division plan for clinical operations and provide for efficient use… more
    Sea Mar Community Health Centers (10/21/25)
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  • Director Reimbursement Design & Market Evaluation

    Highmark Health (Oklahoma City, OK)
    …and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations . **ESSENTIAL RESPONSIBILITIES** + Perform management ... business. This will require aligning new models to the health plan 's strategic objectives based on a...Plan , organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and… more
    Highmark Health (10/29/25)
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  • Manager, Risk Adjustment Operations

    Point32Health (Canton, MA)
    …strong consultative skills. + Working knowledge of both the medical and business side of health plan and provider operations . + Ability to understand and ... members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan...**Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible for the department's… more
    Point32Health (12/25/25)
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  • Senior Business Consultant

    CVS Health (Chicago, IL)
    … insurance experience preferred). + Experience in business consulting, customer experience or health plan operations . + Ability to synthesize information ... At CVS Health , we're building a world of health...synthesis of customer feedback across multiple sources, such as plan sponsors, members, sales and service teams, brokers and… more
    CVS Health (12/24/25)
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  • Producer Management Strategy Consultant

    Highmark Health (Pittsburgh, PA)
    … Network and other affiliated Health Systems, Product & Healthcare Services, Health Plan Operations , Actuarial Services, and Government and Commercial ... educate and engage broker community; support continued development and refinement of health plan 's distribution strategy, utilizing an internal matrixed network… more
    Highmark Health (01/09/26)
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  • Senior Program Manager, Supplemental Benefits…

    UCLA Health (Los Angeles, CA)
    …degree, preferred + Eight or more years in managed care, Medicare Advantage, or health plan operations , including vendor and supplemental benefit management ... the vendor lifecycle + Partner cross-functionally with internal teams (eg, Operations , Compliance, Finance, Product, and Clinical) to ensure accurate benefit… more
    UCLA Health (12/23/25)
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  • Dir Ent Pharmacy Govt Programs

    Health Care Service Corporation (Richardson, TX)
    …and ensure ROI. **PREFERRED JOB REQUIREMENTS** **:** + Knowledge of Medicaid and/or Medicare health plan and PBM operations . + Additional degrees or ... This position is responsible for directing the Medicaid pharmacy operations team and responsible for analyzing and optimizing the...employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan ,… more
    Health Care Service Corporation (01/07/26)
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  • Market President, New Hampshire

    AmeriHealth Caritas (Manchester, NH)
    …+ Demonstrated knowledge and experience in a leadership role in corporate or health plan operations including enrollment, member services, provider ... essential. The Market President will lead the effective and efficient operations of this Health Plan directly and/or indirectly overseeing Medical Affairs,… more
    AmeriHealth Caritas (11/12/25)
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  • Director, Provider Relations

    Commonwealth Care Alliance (Boston, MA)
    operations and satisfaction. * Strong understanding of Medicare and Medicaid health plan operations , including regulatory and compliance requirements. * ... or healthcare operations within a managed care organization, health plan , or integrated delivery system. * Demonstrated success building and managing… more
    Commonwealth Care Alliance (10/18/25)
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