- Elevance Health (Smithfield, RI)
- ** Director I Medicare Operations ** **Location:** This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of ... and Medicaid Services to transform federal health programs. The ** Director I Medicare Operations ** is responsible for directing multiple business function… more
- Humana (Providence, RI)
- … Director is responsible for behavioral health care strategy and/or operations . The Behavioral Health Medical Director work assignments involve moderately ... requires an in-depth evaluation of variable factors. The Behavioral Health Medical Director actively uses their medical background, experience, and judgement to make… more
- CVS Health (Woonsocket, RI)
- …process, drive us to deliver unparalleled results. We are seeking an Executive Director to lead the newly formed **Group Medicare Performance Optimization** ... Network, Medical Economics, Health Care Delivery, Revenue Integrity, Service Operations , as well as the Medicare COE...Integrity, Service Operations , as well as the Medicare COE to optimize the achievement of business performance… more
- Cardinal Health (Providence, RI)
- …team is passionate about helping oncology practices navigate the future. The Director , Managed Care is responsible for strategy and management of managed care ... responsible to implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing… more
- Highmark Health (Providence, RI)
- …and departments to improve Stars and/or Quality Rating outcomes for Medicare Advantage across footprint. Designs, implements and executes strategies and works ... Organization are met and to optimize outcomes. Collaborates with the company's Medicare Advantage matrixed teams to improve processes, procedures and best practices.… more
- Humana (Providence, RI)
- …of our caring community and help us put health first** The Director , Broker Digital Sales (Innovation Portfolio Strategy) utilizes ideas, identifies innovation ... opportunities, and translates ideas into actionable and profitable business. The Director , Innovation Portfolio Strategy requires an in-depth understanding of how… more
- Humana (Providence, RI)
- …Medical Director responsible for behavioral health care strategy and/or operations . The Behavioral Health Medical Director work assignments involve ... Reporting Relationship: This position reports directly to the Cluster Lead Medical Director . **Use your skills to make an impact** **REQUIREMENTS:** + Doctor of… more
- Humana (Providence, RI)
- …a part of our caring community and help us put health first** The Director , Actuarial of Medicaid Pricing provides actuarial support across a broad range of ... actuarial and business needs for specific product lines. The Director , Actuarial requires an in-depth understanding of how organization capabilities interrelate… more
- Humana (Providence, RI)
- …Best Places to Work, and be a part of our dynamic team as the Director of Technology Solutions. We are on a mission to revolutionize our Customer Relationship ... your chance to make a substantial impact! As the Director of Technology Solutions, you will spearhead the strategy...of IT initiatives that are vital to our business operations . Your deep understanding of organizational capabilities and your… more
- Gentiva (Warwick, RI)
- …in people's lives every day. **Overview** We are looking for an **Executive Director Specialist RN** that will travel to many of our branch locations throughout ... complying with all federal and state guidelines. + Experience in hospice operations , state and federal regulations and compliance + Registered Nurse required, BSN… more
- HealthEdge Software Inc (Providence, RI)
- …them: NCQA (National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other ... particularly in the Payer space, with a perspective on how health plan operations impact willingness to adopt digital transformation and innovation + 7+ years'… more
- Prime Therapeutics (Providence, RI)
- …a thorough understanding of operating infrastructure of Strategic Business Unit(s) (SBUs) operations to be able to proactively analyze and identify opportunities for ... and resolving complex problems and issues. + If supporting Medicare Part D, will be responsible for implementing CMS...focus **Reporting Structure** + Reports to Manager or Sr Director in the Finance department **Responsibilities** + 3+ years… more
- Conviva (Providence, RI)
- …the clinical education team and will work also closely with Coding operations team and Clinical Excellence team under the CenterWell Primary Care Organization. ... This role reports to Associate Director of coding education and has a dotted line...with the divisional clinical educator and insights from coding operations team and clinical excellence team. The training responsibilities… more
- Gentiva (Fall River, MA)
- …automobile insurance. Current CPR certification Reports directly to the Executive Director , Administrator, or Senior Patient Care Manager. Responsible for the day ... to day operations of your assigned hospice site, administering the clinical...Managing the site in the absence of the Executive Director , Administrator, or Senior/Executive Patient Care Manager. + Managing… more
- Prime Therapeutics (Providence, RI)
- …the team through the full cycle contract management processes for Commercial, Medicare Part D, Medicaid, and Health Insurance Marketplace and the provider relations ... to pharmacy clients by creating a strong interface between contact center operations and provider relations + Develop and maintain relationships with internal and… more