- Molina Healthcare (Racine, 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 (Racine, 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 (Racine, 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 (Racine, 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
- Lilly (Pleasant Prairie, WI)
- … Lead Team. + Provide direction on the operationalization of the data management action plan including the transition from paper-based processes to digitized ... the site and align with corporate objectives. The Associate Director , Quality Assurance, will also provide computer...the global M&Q Quality Culture as it relates to data management and integrity. Provide … more
- Molina Healthcare (Racine, WI)
- **Job Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment, is responsible for the implementation, monitoring, and oversight ... and data completeness training, onboarding for CDA team members, vendor management for chart collection vendors, Supplemental data , and chart collection… more
- Turner & Townsend (Racine, WI)
- …, Engineering, or a related technical field. + Minimum 8 years in cost management for large, mission-critical construction projects (eg, Data Centers, High Tech, ... our clients with many complex projects, responsible for all aspects of cost management and project delivery. We are seeking an ambitious **Associate Director **… more
- Molina Healthcare (Racine, WI)
- …or Contact Center technology leadership. + 5+ years in a senior management or director -level role overseeing **large-scale, cloud-based UCaaS/CCaaS environments ... **Job Description** **Job Summary** The Director of IT (Telecom) provides strategic and operational...and simplify secure access across channels. + Collaborate with data and analytics teams to leverage AI-driven insights for… more
- Ascension Health (Racine, WI)
- …range at the time of the offer._ **Responsibilities** Direct quality management activities and resources. **Responsibilities:** + Oversee progress of departmental ... respective managers. + Analyze patient and/or resident care information from data sources. Identify real or potentialconcerns and oversee development of… more
- Lilly (Pleasant Prairie, WI)
- …developing and maintaining Manufacturing Execution Systems, QC Systems, QA systems, or data analytics. + Experience with IT service management (ITSM) frameworks ... to those who need them, improve the understanding and management of disease, and give back to our communities...minimizing the impact to our environment. The IT Associate Director -Lilly Kenosha is responsible for the smooth operation… more
- Molina Healthcare (Racine, 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 (Racine, 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 (Racine, 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
- GE HealthCare (Waukesha, WI)
- …large, complex organizations. + Proficiency in resilience tools (eg, Fusion Risk Management , Everbridge, Castellan, etc.), data analysis platforms (eg, Tableau, ... **Job Description Summary** The Senior Director , Resilience, plays a critical leadership role in...risk intelligence into segment strategies to enable proactive risk management and faster response. + Prioritize and lead complex… more
- Molina Healthcare (Racine, 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
- Lilly (Pleasant Prairie, WI)
- …the formulation/filling/inspection of pharmaceutical products. The Associate Director will provide guidance on time management and priorities for direct ... bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to our communities through philanthropy and… more
- Elevance Health (Waukesha, WI)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician and oversees the...you will make an impact:** + Supports the Medical Management staff to ensure timely and consistent responses to… more
- CVS Health (Antioch, IL)
- …targeted improvements as identified and overall staffing support. **Duties:** + Provider Engagement & Relationship Management : Strengthen partnerships with ... Director to develop and implement strategies to streamline, policies, procedures, provider interactions/trainings and optimize workflows. + Data & Insights… more
- Generac Power Systems (Waukesha, WI)
- …technology solutions company, we continue to push new boundaries. **JOB SUMMARY:** The Director NPI Sourcing is aligned with a business group and functions to lead, ... train, and manage a group of NPI specialists. The Director NPI Sourcing will drive material cost savings, delivery,...international capacity + 5 years of experience with project management in a lead capacity role + 5 years… more
- Molina Healthcare (Racine, WI)
- …and problem-solving capabilities. + **Preferred Experience** 10 years + of IT Data Center Operations, Project Management , Cyber Recovery, Business Continuity ... **Job Description** **Job Summary** The Director of Cyber Recovery will oversee and manage...the Network Operating Center (NOC) and Enterprise Business Continuity Management (EBCM) Team. This role is primarily responsible for… more