- Centene Corporation (Jefferson City, MO)
- …complex and often conflicting requirements. + Oversee the operations of utilization management , reconciliation coordination, concurrent review (telephonic and ... compliance with National Committee for Quality Assurance (NCQA) standards for utilization management functions, prior authorization and concurrent review units… more
- Evolent (Jefferson City, MO)
- …**Join Evolent for the mission. Stay** **for** **the culture.** Evolent is hiring a Vice President , Growth - Payer for our growth team. **Role Overview** **s** ... trends and competitive landscape to refine strategy. **About the Role** **s** **:** The Vice President , Growth - Payer will report to the Chief Strategy and… more
- GEHA (Lee's Summit, MO)
- …a personalized customer experience, sustained by a nimble and efficient organization. The Vice President , Pharmacy is a senior executive leader responsible for ... Ratio (MLR), and ensuring integration of pharmacy strategy across population health, utilization management , and quality initiatives for all GEHA products and… more
- Sedgwick (Jefferson City, MO)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Assistant Vice President **PRIMARY PURPOSE** : To provide strategic recommendations and ... to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business lines; and to… more
- Centene Corporation (Jefferson City, MO)
- …million members. **Position Purpose:** Provide strategic and operational direction for utilization management , quality, and administrative or clinical policies, ... Unit and provides clinical liaison to IT department + Assists with utilization management -related activities, as needed. + Performs other duties as assigned +… more
- Datavant (Jefferson City, MO)
- …benchmarking, goal setting, timely execution, and superior leadership. + Strong utilization of SalesForce to include monitoring and documenting member information. + ... Understanding and utilization of P&Ls to assist in reducing cost while...book of business. Qualifications: + Minimum of 5 years management or sales experience in a healthcare environment +… more
- JPMorgan Chase (Clayton, MO)
- …than ~$3MM. You'll focus on business development, acquiring balances, deepening product utilization , and gaining referrals to increase primary bank share. As a ... providing financial advice with a focus on client experience and risk management , while focusing on acquiring new relationships, retaining and deepening existing… more
- HCA Healthcare (Kansas City, MO)
- …and programs to HCA hospitals. + Serves as a resource and consultant to the Vice President Physician Services Group and/or Vice President Business ... review/ management . + Consults with facility-level staff regarding delegated utilization management and disease management operations under managed… more
- BJC HealthCare (St. Louis, MO)
- …through the division of Patient Care Services lead by the Chief Nursing Executive, Vice President of Patient Care Services. The CM Service is comprised of ... three departments: Case Management , Utilization Management , and Social Work. Through the Triad Model of Care Delivery, the objectives of the CM Services are… more
- Burns & McDonnell (Kansas City, MO)
- …The Underground & Submarine Cables (UGSC) Business Leader reports directly to the Vice President of Ascending Business and has the responsibility of overseeing ... renewal processes with clients. + Promote the BMcD Quality Management System and its utilization . + Direct...cables business. All other duties as assigned by the Vice President of Ascending Business. **Qualifications** +… more
- Humana (Jefferson City, MO)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Jefferson City, MO)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Humana (Jefferson City, MO)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- BJC HealthCare (St. Louis, MO)
- …through the division of Patient Care Services lead by the Chief Nursing Executive, Vice President of Patient Care Services. The CM Service is comprised of ... three departments: Case Management , Utilization Management , and Social Work. Through the Triad Model of Care Delivery, the objectives of the CM Services are… more
- Copeland (St. Louis, MO)
- …workforce planning strategies to drive business outcomes. You will partner with the HR Vice President for Enterprise teams to align business needs and HR ... with business leaders on organizational design initiatives and change management and communication plans + Utilization of...and change management and communication plans + Utilization of successional planning, talent review and L&D process… more
- BJC HealthCare (St. Louis, MO)
- …implemented contracts. + Proactively provides input on industry best practices and assist vice president in developing and implementing BJC's short and long term ... country. BJC HealthCare is committed to developing a world class supply chain management organization. Effective management of our supply chain is critical to… more
- Fresenius Medical Center (Florissant, MO)
- …defined by the organization quality goals, by working with the Vice President of Quality and other organization management to ensure that organization/ASC ... staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and… more
- Acosta Group (Kansas City, MO)
- …and initiatives. + **Strategic Utilization :** Leverage insights from Senior Vice President , General Manager, Team Leaders, and Senior Business Managers ... objectives and fostering strong relationships with our customers. Responsible for the management of the assigned customer business in a defined marketing area.… more
- Highmark Health (Jefferson City, MO)
- …outsource Customer/Member communications in physical and digital formats + Ability to conduct Vice President and above outreach within IT and Procurement + ... sales revenue and expanding market share through new client acquisition and relationship management . The ideal candidate will have a strong background in B2B sales,… more
- Evolent (Jefferson City, MO)
- …member of the Legal team, and under general guidance and supervision of the Senior Vice President , Deputy General Counsel, the Attorney will prepare and review a ... care, HIPAA, provider and vendor contracting, compliance, population health (including utilization management ), Medicare, and Medicaid. + Draft, review and… more