- Molina Healthcare (Akron, OH)
- …and ensure adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy. **Knowledge/Skills/Abilities** + ... among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validate data...Integrates work with other teams including New Markets team, Network Management , Product Teams, PDM and IT.… more
- Molina Healthcare (Akron, OH)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. + **Knowledge/Skills/Abilities** + Strategically plans, ... **Job Description** **Job Summary** The Network Solutions Director is responsible for...solutions utilizing provider data such as the Provider Online Directory, Utilization Management , Customer Experience,… more
- Molina Healthcare (Akron, OH)
- …and system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * Strategically plans, ... in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc. * Engages with IT and other departments to… more
- Molina Healthcare (Akron, OH)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Molina Healthcare (Akron, OH)
- …as meeting or exceeding productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, ... guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- BAYADA Home Health Care (Cuyahoga Falls, OH)
- …currently seeking an experienced health care manager to fill the position of **Associate Director ** in our Cuyahoga, OH Senior Living office. Are you looking for an ... care to our clients. **Responsibilities:** + Fully responsible for the management and services including budgeting, planning, recruiting and fiscal management… more
- Molina Healthcare (Akron, OH)
- …the Network Operating Center (NOC) and Enterprise Business Continuity Management (EBCM) Team. This role is primarily responsible for Cyber Recovery activities ... **Job Description** **Job Summary** The Director of Cyber Recovery will oversee and manage...Cloud, disaster recovery, business continuity, team leadership, and project management . + Strong knowledge of application, network ,… more
- Molina Healthcare (Akron, OH)
- …care in the most effective setting. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Determines ... health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure… more
- Cleveland Clinic (Canton, OH)
- …Canton, Plain Township and Tuscarawas County. Mercy also has a growing hospital-owned provider network - Mercy Professional Care Corporation - that offers ... in all aspects of Breast Surgery including both benign and malignant disease management . The ideal candidate will have advanced surgical procedures such as nipple… more