- Molina Healthcare (Green Bay, WI)
- …design solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience, Enrollment, and Claims ... **Job Description** **Job Summary** The Network Solutions Director is responsible for leading a team designing...combination of education and experience **Required Experience** 7-9 years Provider Data **Preferred Education** Graduate Degree or… more
- Molina Healthcare (Green Bay, WI)
- … Information process functions. * Directs the development, implementation and maintenance of provider data in the claims payment system. * Supports critical ... databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of… more
- Molina Healthcare (Green Bay, WI)
- …optimization, and service delivery + Overseeing implementation of scalable solutions for provider onboarding, data management , and credentialing operations + ... **JOB DESCRIPTION** **Job Summary** Lead operational readiness initiatives across provider data and credentialing functions, supporting both new implementations… more
- Molina Healthcare (Green Bay, WI)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management /Network Adequacy. **Knowledge/Skills/Abilities** + ... work with other teams including New Markets team, Network Management , Product Teams, PDM and IT. **Job Qualifications** **REQUIRED...EXPERIENCE:** + Advanced Excel skills. + Power BI. + Provider Data Analytics. To all current Molina… more
- Molina Healthcare (Green Bay, WI)
- …regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization Management ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Green Bay, WI)
- …of value-based care models, provider enablement strategies, and population health management . + Strong knowledge of data integration, EMR systems, and ... programs focused on provider enablement, ensuring access to tools, training, and data for success in VBC models. + Design and implement VBC training programs,… more
- Molina Healthcare (Green Bay, WI)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... Assists in recruitment, hiring and training of staff as needed. + Analyzes data and identifies medical cost savings and quality improvement opportunities. + Accounts… more
- Molina Healthcare (Green Bay, WI)
- …* Provides direct oversight, monitoring and training of local plans' provider dispute and appeals units to ensure adherence with Medicare standards ... and requirements related to non-contracted provider dispute/appeals processing. * Establishes member and non-contracted provider grievance/dispute and appeals… more
- Molina Healthcare (Green Bay, WI)
- …compliance program, including annual, periodic, focal, etc. audits. * Performance Management & KPI Expertise: Develop, implement, and monitor KPIs, including leading ... adherence, diagnose root causes of misses, and drive accountability across functions. * Data Insight & Decision Support: Ingest and interpret complex data from… more
- Grifols Shared Services North America, Inc (Menasha, WI)
- …solutions and services in more than 110 countries and regions. The Director , Pricing & Access Analytics is responsible for developing and applying advanced ... + Track win/loss trends to refine pricing and contracting strategies. Provide insights into pricing and contracting performance and recommend adjustments based… more
- Molina Healthcare (Green Bay, WI)
- …development, implementation, and oversight of technology that drives core utilization management , care management , long-term services and supports (LTSS), ... establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Responsible… more
- The Foth Companies (Green Bay, WI)
- …service desk, printing services, digital asset management (covering software asset management , hardware asset management , data governance, and data ... strategies and systems + Ensure the development, implementation, and management of data governance frameworks, policies, and...field. + 20+ years' experience in IT / technology management , including roles such as IT Director ,… more
- Superior Ambulance Service (Kaukauna, WI)
- …is the largest independent, locally owned, and operated emergency medical services provider in the Midwest. Superior employs more than 2,500 licensed EMT, Paramedics ... Care, helicopter, and fixed wing emergency medical transportation. EMTs and Paramedics provide safe transportation and quality medical care to sick and injured… more
- Molina Healthcare (Green Bay, WI)
- …+ Integrate external data sources and identify automation opportunities in data extraction processes + Provide comprehensive data analysis, including ... **Job Summary** Reporting to the Director of Clinical Informatics for Analytics & Interfaces,...Clinical Informatics for Analytics & Interfaces, the Clinical Informatics Data Analyst is responsible for the development, design, and… more
- Artera (Green Bay, WI)
- …PURPOSE: Manage all claims while under the general supervision of the Claims Director . Provide monthly updates and reporting. Coordination and database ... Work program for injured workers. + Prepare operations and risk reports for management analysis. Provide benchmarking information as necessary. + Analyze and… more
- Amcor (Oshkosh, WI)
- …volumes, and scale-up timing. + **Process Improvement:** Develop and standardize data management processes, collaborating cross-functionally to identify and ... unpack possibility through our innovative and responsible packaging to provide solutions that benefit our customers, our people and...focused mindset. This role will report directly to a Director of Global Key Accounts (GKA), supporting several to… more
- Hy-Vee Food Stores (Ashwaubenon, WI)
- …+ Professionalism Reporting Relations: Accountable and Reports to: District Store Director ; Store Manager; Assistant Manager of; Perishables, Store Operations, and ... Health Wellness Home; Food Service Director ; Market Grille Department Manager Positions that Report to...and on time. Secondary Duties and Responsibilities: + Assumes management duties in absence of Department Manager. + Writes… more
- Fresenius Medical Center (De Pere, WI)
- …financial metrics ie TAP, maintenance parts cost, travel and expenses. + Responsible for data integrity for management systems at the Area level ie PeopleSoft, ... timely manner. + PRINCIPAL RESPONSIBILITIES AND DUTIES: + Overall management of Technical Services for an area. Area will...+ Transport equipment as needed. + Collaborate with the Director of Technical Services to establish operating and financial… more
- Grifols Shared Services North America, Inc (Green Bay, WI)
- …technology for call planning/targeting, field communications, field reporting, sales data analysis, reporting and generating insights. **Territory to include Green ... *Enhanced approach to customer targeting and engagement *Regular use of analytical data to generate field and commercial insights and monthly business planning… more
- Amcor (Oshkosh, WI)
- …At Amcor, we unpack possibility through our innovative and responsible packaging to provide solutions that benefit our customers, our people and our planet. More ... Production System (ALPS). The incumbent will report to the Director of Continuous Improvement and be a member of...and optimize efficiency/productivity. + Motivate, coach, and instill good management skills in all employees engaged in the CI… more