- Prime Therapeutics (Boise, ID)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Sr Care Manager - Remote **Job Description** + Ensures continuity of ... risk stratification of members, monitoring reassessment needs and facilitating transitions of care settings. + Serves as the primary point of member contact. +… more
- Magellan Health Services (Boise, ID)
- …implement solutions that directly influence quality of care . General Job Information Title Care Manager (UM/UR) - Remote , Idaho Licensed Grade 24 Work ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes… more
- Sharecare (Boise, ID)
- **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 (Boise, ID)
- …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
- Prime Therapeutics (Boise, ID)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Manager Financial Systems - Remote **Job Description** The Manager , Financial ... 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 (Boise, ID)
- …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 (Boise, ID)
- …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
- Sedgwick (Boise, ID)
- …Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Client Performance Manager | Dedicated Client | Remote **PRIMARY PURPOSE** **:** ... Taking care of people is at the heart of...of everything we do, and we start by taking care of you, our valued colleague. A career at...the right candidate for this or other roles.** **Taking care of people is at the heart of everything… more
- UMB Bank (Boise, ID)
- …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
- Molina Healthcare (Meridian, ID)
- **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 (Meridian, ID)
- **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 (Meridian, ID)
- **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 (Meridian, ID)
- …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 (Meridian, ID)
- …+ Understanding of complex configuration solutions + Advanced knowledge of health care benefits. + Advanced knowledge of healthcare claims and claim processing from ... receipt through encounter submission. + Ability to adopt and utilize work tracking software + Strong business writing skills; proficient user of Microsoft Products including Word, Excel, Outlooks, Teams, SharePoint, PowerPoint, and Visio + Advanced knowledge… more
- Molina Healthcare (Meridian, ID)
- …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 (Boise, ID)
- …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
- CDM Smith (Meridian, ID)
- …CDM Smith office, in the US nationwide. We offer in office, hybrid, or remote working environments allowing for flexible work options.** We currently have an opening ... other duties as assigned. **Job Title:** Senior Contract Administrator (fully remote work options) **Group:** FAO - Contracts **Employment Type:** Regular **Minimum… more
- Magellan Health Services (Boise, ID)
- …stakeholders internally and externally. Provides clinical reviews of Quality of Care (QOC) and Critical/Adverse incidents related to clinical services. + Audits ... and reviews case manager and provider clinical documentation and telephone interactions against...+ Conducts ongoing activities which monitor established quality of care standards in the participating provider network and for… more
- Prime Therapeutics (Boise, ID)
- …every decision we make. **Job Posting Title** Employer Account Executive - Remote **Job Description** The Employer Account Executive serves as the primary ... relationship manager for multiple employer/administrative services only (ASO) accounts. This...environment **Preferred Qualifications** + PBM, health plan, or health care experience **Minimum Physical Job Requirements** + Ability to… more
- Prime Therapeutics (Boise, ID)
- …make. **Job Posting Title** Sr Perimeter Network Engineer - Palo Alto - Remote **Job Description** The Systems Engineer Senior IT is responsible for constructing ... + Experience with Palo Alto Prisma Access, Strata Cloud Manager and Cloud Identity Engine + Regulatory compliance requirements...PCI, etc.) + Previous experience in PBM / health care industry + Understanding of security implications of domain… more