- CVS Health (Woonsocket, RI)
- …deliver solutions to make health care more personal, convenient and affordable. The ** Lead Director ,** ** Medicaid Provider Experience Standardization** ... is responsible for ensuring the variations that currently exist across multiple Medicaid Health plans specific to provider contracting, credentialing, … more
- CVS Health (Woonsocket, RI)
- …and deliver solutions to make health care more personal, convenient and affordable. The Lead Director , Provider Data Governance will develop, enhance, and ... all provider information is accurately recorded and maintained to provide for proper reimbursement and member access (eg, directory listings). Aligns policies… more
- Humana (Providence, RI)
- …of providing frameworks to maximize available resources to achieve growth. The ** Director ,** ** Medicaid Insurance Product Management - Growth & Innovation** will ... a part of our caring community and help us put health first** Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy… more
- Humana (Providence, RI)
- …our caring community and help us put health first** The Clinical Pharmacy Provider Engagement Associate Director , HPS Clinical Program Strategy, partners with ... for Humana health plans by creating advocacy through key Provider Groups. This role will lead a...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Cardinal Health (Providence, RI)
- …patient throughout the continuum of care. The team's mission is to provide exceptional clinical, supply chain, analytics, and operational expertise to improve ... for hospital pharmacies. This position serves as one of Cardinal Health's Lead 340B Consultants within our Innovative Delivery Solutions (IDS) business. The … more
- Humana (Providence, RI)
- …as directed. May participate on project teams or organizational committees. Reports to a Lead Medical Director . **Required Qualifications** + MD or DO degree + ... on quality management or utilization management. **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization… more
- Humana (Providence, RI)
- …**Additional Information** Typically reports to a Regional Vice President of Health Services, Lead , or Corporate Medical Director , depending on size of region or ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Providence, RI)
- …**Additional Information** Typically reports to a Regional Vice President of Health Services, Lead , or Corporate Medical Director , depending on size of region or ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Providence, RI)
- …an impact** Additional Information Typically reports to a Regional/Associate Vice President, Lead , or Corporate Medical Director , depending on size of region ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Providence, RI)
- …requests received by members of the Medicare population and reports to the Lead Medical Director . **Other duties:** + Identify medical management operational ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Providence, RI)
- …caring community and help us put health first** The Associate Director , Actuarial Analytics/Forecasting analyzes and forecasts financial, economic, and other data ... to provide accurate and timely information for strategic and operational...medium and long-term financial and competitive position. The Associate Director , Actuarial Analytics/Forecasting requires a solid understanding of how… more
- Humana (Providence, RI)
- … leading-edge solutions to drive enhanced data business decision-making. The Associate Director , Cloud Architecture will lead team development and core ... our caring community and help us put health first** The Associate Director , Cloud Architecture designs, builds, and maintains data processing architectures and… more
- Humana (Providence, RI)
- …a part of our caring community and help us put health first** Associate Director , Enterprise API Standards and Governance is a pivotal role in leading the technology ... **architectures** , and patterns including any interim/transition states + Lead creation of standard **integration** products, capabilities and architecture patterns… more
- Public Consulting Group (Providence, RI)
- …intersection and overlap between our Special Education/Case Management and school-based Medicaid services work within a state; regularly engage with counterparts + ... + Partner on business development initiatives, including: demonstrations, proposals ( lead proposal writing teams, including writing sections, coordinating efforts,… more
- Humana (Providence, RI)
- …help us put health first** You have the unique opportunity to contribute as a lead for a technology team that is focused on delivering modern mobile solutions for ... one of the leading healthcare organizations. Reporting to the Associate Director of our Experience Team and partnering with Architecture and Product teams, you will… more
- Humana (Providence, RI)
- …to join the team working remote anywhere in the US. The Tech Enablement Lead role reports directly to the Director , Technology, Measurement, & Optimization and ... mobile. Additionally, they will have a strong ability to provide guidance to technical teams and campaign teams as...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Fallon Health (Dartmouth, MA)
- …improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and ... activities to penetrate accounts listed on the plan. 1. Lead Generation + Works collaboratively with SE enrollment team...market intelligence to the SE Manager and the Outreach/Enrollment Director so that adjustments can be made to tactical… more
- Prime Therapeutics (Providence, RI)
- …Analyst assists in the implementation of Prime's compliance programs and may lead some initiatives within their designated areas and partners with key internal ... operating procedures; escalate issues to Compliance leadership as appropriate + Lead project management efforts for highly sensitive Compliance initiatives +… more
- Prime Therapeutics (Providence, RI)
- …operations are aligned with applicable laws and regulatory guidance. + Provide consultative leadership and direct efforts to communicate compliance program ... elements, regulations and laws, and consequences of non-compliance. + Lead successful implementation of projects and initiatives, including developing, leading… more
- Prime Therapeutics (Providence, RI)
- …and participates in committee review meetings within the Commercial, Medicare, Medicaid , and Health Insurance Marketplace for the assigned department. This position ... and Government Programs Compliance Committee Meetings to monitor new regulations and provide necessary updates to these committees + Monitor national and state… more