• Manager, Consumer Service Operations - Florida…

    Humana (Tallahassee, FL)
    …and analyses of processes and/or systems, to meet contractual SLAs. + Utilize process improvement methodology to identify, design and execute initiatives to ... market governance structure in reviewing pertinent data, member feedback and identifying process improvement opportunities This position must reside in the state… more
    Humana (12/04/25)
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  • Medicaid Contract Implementation Management…

    Elevance Health (Indianapolis, IN)
    …local provider network strategy. + Leads cross functional project initiatives and process improvement activities. **Minimum Requirements:** + Requires a BA/BS ... ** Medicaid Contract Implementation Management Director** **Location** : Indianapolis,...financial, legal, or other escalated issues. + Acts as lead to assigned shared services partners on behalf of… more
    Elevance Health (11/26/25)
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  • VP, Health Engagement - Medicaid

    Highmark Health (Pittsburgh, PA)
    …solutions with seamless omni-channel handoffs. As a key leader of the Medicaid Clinical organization, role is responsible for maximizing and optimizing value of ... operational excellence/administrative cost management. This requires the incumbent to lead their team through the implementation of alternative resourcing strategies… more
    Highmark Health (11/15/25)
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  • Lead Analyst, Quality Analytics…

    Molina Healthcare (TX)
    **Job Summary** The Lead Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting ... for development team(s). *Identifies, defines and plans software engineering process improvements and verifies compliance. *Mentors and trains systems/programmer… more
    Molina Healthcare (11/16/25)
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  • Procurement Process Excellence Lead

    Humana (Washington, DC)
    …part of our caring community and help us put health first** The Procurement Process Excellence Lead drives continuous improvement and operational excellence ... Humana is seeking a Procurement Process Excellence Lead is responsible for driving continuous improvement ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
    Humana (11/21/25)
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  • Director Quality Improvement

    Banner Health (Scottsdale, AZ)
    …entity leadership to plan and coordinate local Quality Councils/QAPIs. 2. Performance and Process Improvement -Serves as a subject matter expert in performance ... teams. CORE FUNCTIONS 1. Quality Leadership and Integration - Lead the integration of quality into the fabric of...and process improvement , project management and change management… more
    Banner Health (12/06/25)
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  • Encounter Data Management Lead

    Humana (Frankfort, KY)
    …community and help us put health first** The Encounter Data Management Lead supports the Encounter Data Management team within the Healthcare Quality Reporting ... and Improvement (HQRI) organization. This position is responsible for ensuring...the accurate and timely submission of encounter data to Medicaid , Medicare, and DSNP states, while maintaining adherence to… more
    Humana (11/26/25)
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  • Encounter Data Management Lead

    Humana (Frankfort, KY)
    …Power Platform (Power BI, Power Automate, & Power Apps) + Knowledgeable in process improvement and metrics development + Knowledgeable in regulations governing ... community and help us put health first** The DSNP Encounters Data Management Lead supports the Encounter Data Management team within the Healthcare Quality Reporting… more
    Humana (10/29/25)
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  • Application Support Specialist Lead

    AmeriHealth Caritas (West Chester, PA)
    …will support a state government healthcare system (LTSS). In this role, you will lead a team that helps keep the system stable, improve processes, and resolves ... must live in EST or CST time zones **Responsibilities:;** + Oversee and lead a team of production staff, including assigning tasks, monitoring workload &… more
    AmeriHealth Caritas (11/13/25)
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  • Care Management Educator Lead PRN

    AdventHealth (Maitland, FL)
    …gathering, change implementation, and evaluation of outcomes. + Is supportive of Process Improvement Initiatives by sponsoring and/or participating in the ... Altamonte Spgs Fl **The role you'll contribute:** The Care Manager System Educator Lead (CMEL) is a care management professional who supports the Director of System… more
    AdventHealth (11/13/25)
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  • Lead Customer Solution Center Appeals…

    LA Care Health Plan (Los Angeles, CA)
    …to acceptable levels. Recommend and implement resolutions, new processes, and/or process improvement . Provides accurate and timely written statistical reports ... A&G cases for all line of business (LOB). The Lead will assist in identifying areas of improvement...Ensure team effectiveness and project completion. Duties Review and process complex and/or escalated clinical A&G cases. Analyze the… more
    LA Care Health Plan (11/11/25)
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  • Senior Management Analyst

    Clark County, NV (Las Vegas, NV)
    …identifying process improvements, and maintaining compliance with federal and state Medicaid regulations. As a lead member of our team, Senior Management ... Analyst. This position will support the Fiscal, Grants, Contracts, and Medicaid program operations. These supervisory positions provide leadership and oversight in… more
    Clark County, NV (12/03/25)
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  • Lead , Data Quality/Integrity - HEDIS…

    Humana (Denver, CO)
    …Additionally, this role will be instrumental in our department's continuous process improvement , operational excellence objectives, and quality management. ... a part of our caring community and help us put health first** The Lead , Data Quality/Integrity understands end-to-end master data processes and flows and uses that… more
    Humana (11/26/25)
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  • Facilities Portfolio Management Lead

    Humana (Louisville, KY)
    …community and help us put health first** The Facilities Portfolio Management Lead ensures the optimal utilization of the organization's facilities. The Facilities ... Portfolio Management Lead works on problems of diverse scope and complexity... ensures the optimal facility operation and leads cost improvement initiatives of the facilities within their responsibilities and… more
    Humana (12/05/25)
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  • Lead Product & Strategy Manager - Provider…

    Humana (Baton Rouge, LA)
    …community and help us put health first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and providers, with full ... accountability from strategy to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of the multidisciplinary… more
    Humana (12/04/25)
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  • Collection Lead / Medical

    BrightSpring Health Services (Englewood, CO)
    …growing network of branches and healthcare professionals. The RCM Ancillary Services Team Lead will be capable of performing all activities related to the tracking ... and providing Revenue Cycle Management (RCM) support . The RCM Ancillary Services Team Lead will be the primary resource for all employees of the RCM Ancillary… more
    BrightSpring Health Services (10/15/25)
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  • Procurement Lead

    Humana (Frankfort, KY)
    …our caring community and help us put health first** The Procurement Lead generates and implements efficient sourcing and category management strategies. Manages the ... company's supply portfolio ensuring transparency of spending. The Procurement Lead works on problems of diverse scope and complexity ranging from moderate to… more
    Humana (12/05/25)
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  • Lead , Orchestration

    Humana (Frankfort, KY)
    …campaign status, engagement metrics, and delivery health. + Identify opportunities for process improvement and contribute to the evolution of orchestration best ... operations to deliver more personalized, timely, and effective member communications. As Lead , Orchestration, you will play a key role in coordinating campaign… more
    Humana (12/05/25)
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  • Learning Design Lead - AI

    Humana (Arlington, VA)
    …caring community and help us put health first** The AI Learning Design Lead plays a critical role in designing, developing, and delivering strategic learning ... alignment between business goals and learning outcomes. The Learning Design Lead analyzes content, organizes content, designs solutions, and writes storyboards,… more
    Humana (11/01/25)
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  • Lead Business Analyst - Managed Care…

    Molina Healthcare (Cleveland, OH)
    **JOB DESCRIPTION** **Job Summary** Provides lead level support for accurate and timely intake and interpretation of regulatory and/or functional requirements ... Leads coordinated development and ongoing management / interpretation review process , committee structure and timing with key partner organizations. +… more
    Molina Healthcare (11/21/25)
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