- Molina Healthcare (Davenport, IA)
- …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 (Davenport, IA)
- … 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 (Davenport, IA)
- …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 (Davenport, IA)
- …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 (Davenport, IA)
- …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 (Davenport, IA)
- …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 (Davenport, IA)
- …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 (Davenport, IA)
- …* 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 (Davenport, IA)
- …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
- Molina Healthcare (Davenport, IA)
- …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
- Enviri Corporation (Davenport, IA)
- …40% of the time. . Visits each Service Center in the district regularly to provide direct management oversight for each location. . Willingness and ability to ... Clean Earth is a leading provider of environmental services in the United States...location** Under the general guidance of the Regional Service Director , the District Service Manager will lead a team… more
- Molina Healthcare (Davenport, IA)
- …+ 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
- Davenport Community Schools (Davenport, IA)
- …Major Responsibilities, Summary of Key Duties, Special Assignments, Relationships) + Provide administrative support by managing the Executive Director 's ... and distribute detailed meeting minutes with action items. + Provide leadership and support for the Student and Family...Education, and the AEA. + Develops and maintains several data bases and generates reports + Manages and maintains… more
- Hy-Vee Food Stores (Milan, IL)
- …Professionalism Reporting Relations: Accountable and Reports to: District Store Director ; Assistant Managers Operations; Perishables; Health Wellness Home, Meat ... and on time. Secondary Duties and Responsibilities: + Assumes management duties in absence of Department Manager. + Wraps,...the ability to file, post, and mail materials; copy data from one record to another; interview to obtain… more