- Sharecare (Santa Fe, NM)
- **Job Description:** **Job Summary:** The Care Manager supports the implementation of the Value Based Care Management program in an appropriate and efficient ... telephonic Case or Care Management with CareFirst members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary care … more
- Highmark Health (Santa Fe, NM)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. + Function in accordance with applicable ... utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization,… more
- Highmark Health (Santa Fe, NM)
- …consistent with established industry and corporate standards and are within the care manager 's professional discipline. Effectively function in accordance with ... **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote - Part Time - Weekends Required.** This job implements the effective utilization… more
- Wolters Kluwer (Santa Fe, NM)
- …will live in the eastern time zone area._** The **Customer Success Manager , Lippincott Solutions** is responsible for driving the implementation of all Nursing ... the industry. **Additional Information** : Lippincott Solutions for Patient Care | Wolters Kluwer (https://www.wolterskluwer.com/en/solutions/lippincott-solutions) **Responsibilities:** * Maintains, extends,… more
- Prime Therapeutics (Santa Fe, NM)
- …our passion and drives every decision we make. **Job Posting Title** Employer Account Manager - Remote **Job Description** The Account Manager is responsible ... for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded...and work collaboratively to provide the highest quality of care and service to our members. If you are… more
- Prime Therapeutics (Santa Fe, NM)
- …our passion and drives every decision we make. **Job Posting Title** Pharmacist Account Manager - New York Remote **Job Description** + Leads the development of ... and operational framework. + Revenue Generation - Works jointly with Account Manager to ensure revenue goals, administrative expenses are managed. + Develops strong… more
- UMB Bank (Santa Fe, NM)
- …supporting each other to achieve this goal. As a **Senior Project Manager ** , you will lead multiple enterprise projects interacting with cross-functional teams ... Thu on-site) for candidates in the Kansas City area and open to qualified remote candidates outside of the Kansas City area but within the US.** **_How you'll… more
- Prime Therapeutics (Santa Fe, NM)
- …our passion and drives every decision we make. **Job Posting Title** Sr. Account Manager - Remote **Job Description** Overall management of assigned book of ... or services that includes demonstrating the knowledge of the dynamics facing managed care in the current market. + Understands about the company's business and… more
- Highmark Health (Santa Fe, NM)
- **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Fully Remote ** This job has primary ownership and oversight over a specified panel of members ... in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to… more
- RELX INC (Santa Fe, NM)
- Project Manager II Are you a technical Project Manager looking to work with an industry leading organization? Are you wanting to expand your knowledge within the ... to enhance investigations. About the Role As a Project Manager , you will be responsible for driving and managing...Hospital Indemnity + Family Benefits, including bonding and family care leaves, adoption and surrogacy benefits + Health Savings,… more
- Sharecare (Santa Fe, NM)
- …individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com ... . **Job Summary:** The Manager of Operations, Medical Record Retrieval has an overall...in a consistent, timely, and highly professional manner. The Manager of Operation ensures objectives, principals, values, mission and… more
- Molina Healthcare (Santa Fe, NM)
- **Job Description** **Job Summary** The Lead Risk and Quality Performance Manager supports Molina's Risk & Quality Solutions (RQS) team by overseeing large programs ... quality strategies and solutions to close quality and risk care gaps. * Identify potential risks and execute mitigation...mastery of the drivers of value in managed health care as well as in-depth knowledge of the healthcare… more
- Molina Healthcare (Santa Fe, NM)
- **Job Description** **Job Summary** The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position ... through sequential transformations and identify opportunities to close quality and risk care gaps. * Proactively communicate risks and issues to stakeholders and… more
- Molina Healthcare (Santa Fe, NM)
- **Job Description** **Job Summary** The Sr Risk & Quality Performance Manager is a tactical execution role that will lead specific projects to support Molina's Risk ... through sequential transformations and identify opportunities to close quality and risk care gaps. * Identify potential risks and execute mitigation strategies. *… more
- Molina Healthcare (Santa Fe, NM)
- …experience. + Operational Process Improvement experience. + 2-3 years of Managed Care experience. + Experience with Microsoft Project, Excel, Teams, PowerPoint and ... : * 5-7 years of Program and/or Project management experience.* Managed Care experience. * Experience working in a cross functional highly matrixed organization.… more
- Molina Healthcare (Santa Fe, NM)
- …Education** Advanced clinical degree or advanced public health or health care administration degree **Preferred Experience** * State QI experience * Medicaid ... and/or Medicare QI + **Databricks** + **Development leading indicators and data visualization** + **Informatics** + **SQL** + **Power BI** **Preferred License, Certification, Association** * Black Belt in Lean/Six-Sigma To all current Molina employees: If you… more
- Sharecare (Santa Fe, NM)
- …and accurately explains the VBCM program and schedules appointments between member and Care Manager using shared calendar. + Utilizes email to communicate ... individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com… more
- Merck (Santa Fe, NM)
- …to enhance data capabilities. (10%) **Impact:** Under the supervision of their manager , the Sr. GTOS identifies for the CSSM organization strategies and tactics ... in developing and implementing mitigation strategies when needed. Collaborates with manager to align the operational execution plan with divisional scorecard… more
- Prime Therapeutics (Santa Fe, NM)
- …and drives every decision we make. **Job Posting Title** Proposal Writer - Remote **Job Description** The Proposal Writer is responsible for responding to requests ... strategic positioning and messaging as directed by the sales lead, account manager , and/or client; identify and organize appropriate exhibits to effectively support… more
- Molina Healthcare (Santa Fe, NM)
- …Further details to be discussed during our interview process. This is a remote position. Work hours: Monday- Friday: 8:00am -5:00pm. Michigan RN license preferred. + ... align with Molina auditing policy and protocols + Assists Manager with data for team member performance reviews +...audits, as needed. + Audits for clinical gaps in care from a medical and/or behavioral perspective to ensure… more